Healthcare Provider Details

I. General information

NPI: 1730789611
Provider Name (Legal Business Name): LINDSAY KRISTINE CALL LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 N. BIG HOLLOW RD
PEORIA IL
61615-2451
US

IV. Provider business mailing address

617 W. BEECH ST.
CHILLICOTHEE IL
61523
US

V. Phone/Fax

Practice location:
  • Phone: 309-692-6622
  • Fax: 309-692-6952
Mailing address:
  • Phone: 309-696-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.012
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: