Healthcare Provider Details

I. General information

NPI: 1831785567
Provider Name (Legal Business Name): LINDSEY KINGSLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16535 W BLUEMOUND RD STE 200
BROOKFIELD WI
53005-5906
US

IV. Provider business mailing address

W295S5278 HOLIDAY OAK CT
WAUKESHA WI
53189-9043
US

V. Phone/Fax

Practice location:
  • Phone: 262-999-3495
  • Fax:
Mailing address:
  • Phone: 262-215-9394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7440125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: