Healthcare Provider Details

I. General information

NPI: 1699122432
Provider Name (Legal Business Name): LINDSEY ANN YORK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDSEY YORK LMSW

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HUNTINGTON RD STE 703
ATHENS GA
30606-7214
US

IV. Provider business mailing address

1 HUNTINGTON RD STE 703
ATHENS GA
30606-7214
US

V. Phone/Fax

Practice location:
  • Phone: 706-425-8900
  • Fax: 706-425-8600
Mailing address:
  • Phone: 706-425-8900
  • Fax: 706-425-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCSW006209
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMSW006439
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: