Provider Demographics
NPI:1649656455
Name:NOWACKI, LINDSEY (LCSW)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:NOWACKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 SW GREYSTONE CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6011
Mailing Address - Country:US
Mailing Address - Phone:971-262-9150
Mailing Address - Fax:
Practice Address - Street 1:15700 SW GREYSTONE CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6011
Practice Address - Country:US
Practice Address - Phone:971-262-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0110001041C0700X
ORL147531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical