Healthcare Provider Details

I. General information

NPI: 1376176677
Provider Name (Legal Business Name): LINDSAY GEBEL MA, LCMHCA, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2020
Last Update Date: 02/15/2020
Certification Date: 02/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9624 BAILEY RD STE 290
CORNELIUS NC
28031-6120
US

IV. Provider business mailing address

PO BOX 19893
CHARLOTTE NC
28219-0893
US

V. Phone/Fax

Practice location:
  • Phone: 704-564-0300
  • Fax: 425-696-2262
Mailing address:
  • Phone: 704-975-0703
  • Fax: 704-973-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA11916
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: