Healthcare Provider Details

I. General information

NPI: 1487376950
Provider Name (Legal Business Name): LINDSEY MATTHEWS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 FULTON ST E STE 526
GRAND RAPIDS MI
49503-3269
US

IV. Provider business mailing address

417 WASHINGTON ST SE
GRAND RAPIDS MI
49503-4458
US

V. Phone/Fax

Practice location:
  • Phone: 616-805-3660
  • Fax:
Mailing address:
  • Phone: 517-881-8932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401224663
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401224663
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: