Healthcare Provider Details

I. General information

NPI: 1275280026
Provider Name (Legal Business Name): LINDSAY E LENNERTZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 CONSTITUTION AVE NE STE 3
ALBUQUERQUE NM
87110-5931
US

IV. Provider business mailing address

6020 CONSTITUTION AVE NE STE 3
ALBUQUERQUE NM
87110-5931
US

V. Phone/Fax

Practice location:
  • Phone: 505-278-0447
  • Fax: 888-251-2027
Mailing address:
  • Phone: 505-278-0447
  • Fax: 888-251-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY ELIZABETH LENNERTZ
Title or Position: PSYD
Credential:
Phone: 505-278-0447