Healthcare Provider Details

I. General information

NPI: 1841815594
Provider Name (Legal Business Name): LINDSEY ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1969 W HART RD
BELOIT WI
53511-2230
US

IV. Provider business mailing address

74 ECLIPSE CTR
BELOIT WI
53511-3550
US

V. Phone/Fax

Practice location:
  • Phone: 608-364-5011
  • Fax:
Mailing address:
  • Phone: 608-361-0311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11449-123
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131863
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: