Provider Demographics
NPI:1700507738
Name:BIRRELL, LINDSEY MARIE (LLMSW, SSW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:BIRRELL
Suffix:
Gender:F
Credentials:LLMSW, SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2262 WOODVIEW DR APT 366
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-6814
Mailing Address - Country:US
Mailing Address - Phone:734-895-5302
Mailing Address - Fax:
Practice Address - Street 1:2750 CARPENTER RD STE 5
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1170
Practice Address - Country:US
Practice Address - Phone:734-895-5302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851110301104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker