Healthcare Provider Details

I. General information

NPI: 1417474925
Provider Name (Legal Business Name): LINDSAY ANN MARINE LCPC, CAC-AD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 RIVERSIDE DR STE 8
SALISBURY MD
21801-5352
US

IV. Provider business mailing address

540 RIVERSIDE DR STE 8
SALISBURY MD
21801-5352
US

V. Phone/Fax

Practice location:
  • Phone: 410-548-3333
  • Fax: 410-548-3341
Mailing address:
  • Phone: 410-548-3333
  • Fax: 410-543-3341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: