Provider Demographics
NPI:1831767391
Name:LINDSAY, AUDREA T
Entity type:Individual
Prefix:MS
First Name:AUDREA
Middle Name:T
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 PIERMONT CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5667
Mailing Address - Country:US
Mailing Address - Phone:336-602-7403
Mailing Address - Fax:
Practice Address - Street 1:326 N SPRING ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2722
Practice Address - Country:US
Practice Address - Phone:336-631-1948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health