Healthcare Provider Details

I. General information

NPI: 1407630379
Provider Name (Legal Business Name): LINDSAY YEAGER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 FREEMAN ST APT 4B
BROOKLYN NY
11222-1568
US

IV. Provider business mailing address

190 FREEMAN ST APT 4B
BROOKLYN NY
11222-1568
US

V. Phone/Fax

Practice location:
  • Phone: 845-558-0277
  • Fax:
Mailing address:
  • Phone: 845-558-0277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number119882
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: