Provider Demographics
NPI:1881626455
Name:CARPENTER, LINDALYN (PHYD)
Entity type:Individual
Prefix:DR
First Name:LINDALYN
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:PHYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13605
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-3605
Mailing Address - Country:US
Mailing Address - Phone:336-547-1877
Mailing Address - Fax:
Practice Address - Street 1:2000 PISGAH CHURCH RD
Practice Address - Street 2:STE 100
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-3303
Practice Address - Country:US
Practice Address - Phone:336-288-6165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2640103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000136Medicaid