Provider Demographics
NPI:1770880114
Name:HOCKENBERRY, LINDSAY ALISON (MA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ALISON
Last Name:HOCKENBERRY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:HICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:704 EMMET STREET
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2910
Mailing Address - Country:US
Mailing Address - Phone:231-347-5511
Mailing Address - Fax:231-347-5422
Practice Address - Street 1:704 EMMET STREET
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2910
Practice Address - Country:US
Practice Address - Phone:231-347-5511
Practice Address - Fax:231-347-5422
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MI6401012350103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401012350OtherLICENSE #