Healthcare Provider Details

I. General information

NPI: 1144388596
Provider Name (Legal Business Name): CARLEY GAGE LINDSAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S ELLIOTT RD STE 200
NEWBERG OR
97132-2183
US

IV. Provider business mailing address

901 BRUTSCHER ST STE D-353
NEWBERG OR
97132-6095
US

V. Phone/Fax

Practice location:
  • Phone: 503-706-5197
  • Fax:
Mailing address:
  • Phone: 503-706-5197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLO941
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: