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NPI Code Detail

MEDICARE: LINDSEY ROSE ANDERSON LCSW

MEDICARE: LINDSEY ROSE ANDERSON LCSW
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
11041C0700XClinical Social WorkerI.2102891OH
21041C0700XClinical Social Worker34008997AIN

General Provider Information

NPI Number : 1407505472
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY ROSE ANDERSON LCSW
Provider Business Mailing Address
First Line : 3114 TONAWANDA DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-6352
Country : US
Telephone Number : 419-605-6836
Fax Number :
Provider Business Practice Location Address
First Line : 4656 W JEFFERSON BLVD STE 285
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-6838
Country : US
Telephone Number : 260-422-9372
Fax Number : 260-422-0843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2022
Last Update Date : 09/22/2022

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Directions to “ LINDSEY ROSE ANDERSON LCSW” Practice Location

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