Healthcare Provider Details

I. General information

NPI: 1720260938
Provider Name (Legal Business Name): LINDSEY GONZALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9402 OAK ORCHARD CT
NEW WINDSOR MD
21776-7707
US

IV. Provider business mailing address

9402 OAK ORCHARD CT
NEW WINDSOR MD
21776-7707
US

V. Phone/Fax

Practice location:
  • Phone: 703-772-4599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21661
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: