Provider Demographics
NPI:1649900259
Name:LINGARD BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:LINGARD BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NILES
Authorized Official - Last Name:LINGARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-817-7168
Mailing Address - Street 1:396 WASHINGTON ST # 152
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6209
Mailing Address - Country:US
Mailing Address - Phone:215-817-7168
Mailing Address - Fax:857-232-1651
Practice Address - Street 1:396 WASHINGTON ST # 152
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6209
Practice Address - Country:US
Practice Address - Phone:781-214-0604
Practice Address - Fax:857-232-1651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health