Provider Demographics
NPI:1801445275
Name:CORSO, LINDSEY MEREDITH (LMSW)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MEREDITH
Last Name:CORSO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9396 E PICKWICK CIR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3854
Mailing Address - Country:US
Mailing Address - Phone:313-720-9911
Mailing Address - Fax:
Practice Address - Street 1:210 W HIGHLAND RD STE 102
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4573
Practice Address - Country:US
Practice Address - Phone:248-529-3167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011053221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical