Healthcare Provider Details

I. General information

NPI: 1912459785
Provider Name (Legal Business Name): LINDSAY HODGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY DYKES

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E WALNUT ST
INDIANAPOLIS IN
46204-1312
US

IV. Provider business mailing address

340 WINTERSET WAY
GREENWOOD IN
46143-7715
US

V. Phone/Fax

Practice location:
  • Phone: 949-939-7239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: