Healthcare Provider Details

I. General information

NPI: 1982517827
Provider Name (Legal Business Name): AMY ELIZABETH CARNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY ELIZABETH LINDSTROM

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3731 ROME DR STE A
LAFAYETTE IN
47905-4490
US

IV. Provider business mailing address

6231 GALLEGOS DR
WEST LAFAYETTE IN
47906-5799
US

V. Phone/Fax

Practice location:
  • Phone: 765-227-3764
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22006122A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: