Healthcare Provider Details

I. General information

NPI: 1508702879
Provider Name (Legal Business Name): LINDSAY STAGER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 VETERANS MEMORIAL PKWY
RIVERSIDE RI
02915-5061
US

IV. Provider business mailing address

19 HAMMOND ST
PROVIDENCE RI
02909-1231
US

V. Phone/Fax

Practice location:
  • Phone: 401-432-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS02444
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: