MEDICARE: LINDSEY ARIN GORDON M.A., LLP

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	106S00000X	Behavior Technician
2	103TC0700X	Clinical Psychologist	6361008013	MI

General Provider Information

NPI Number	:	1457841561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY ARIN GORDON M.A., LLP

Provider Business Mailing Address
First Line	:	37935 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3035
Country	:	US
Telephone Number	:	248-987-4877
Fax Number	:

Provider Business Practice Location Address
First Line	:	37935 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3035
Country	:	US
Telephone Number	:	248-987-4877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	11/05/2024

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