Provider Demographics
NPI:1952690497
Name:COLVIN, LYNDSAY (PSYD)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:
Last Name:COLVIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 CARRINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-7154
Mailing Address - Country:US
Mailing Address - Phone:513-895-1643
Mailing Address - Fax:
Practice Address - Street 1:3909 CARRINGTON WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-7154
Practice Address - Country:US
Practice Address - Phone:513-895-1643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07656103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical