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NPI Code Detail

MEDICARE: LINDY A LANDREAUX LCSW

MEDICARE: LINDY A LANDREAUX 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 Worker10271-CAR

General Provider Information

NPI Number : 1962154567
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDY A LANDREAUX LCSW
Provider Business Mailing Address
First Line : PO BOX 1326
Second Line :
City : MARSHALL
State : TX
Zip : 75671-1326
Country : US
Telephone Number : 903-927-3782
Fax Number : 903-927-1764
Provider Business Practice Location Address
First Line : 4077 JEFFERSON AVE
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-1509
Country : US
Telephone Number : 870-330-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2022
Last Update Date : 02/02/2026

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