MEDICARE: LINDSEY THERAPY SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1184259475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDSEY THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	P.O. BOX 1101
Second Line	:
City	:	KIHEI
State	:	HI
Zip	:	96753
Country	:	US
Telephone Number	:	808-280-4577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1847 SOUTH KIHEI RD.
Second Line	:	#205
City	:	KIHEI
State	:	HI
Zip	:	96753
Country	:	US
Telephone Number	:	808-280-4577
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. TIMOTHY JOSEPH SOLOMON LINDSEY
Credential	:	LMFT
Telephone Number	:	808-280-4577

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	03/06/2020

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