=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124571278
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BETH A LINDLEY LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2016
-----------------------------------------------------
Last Update Date | 09/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2700 DAVITT ST STE 1A
-----------------------------------------------------
City | SAULT SAINTE MARIE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49783-3533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-871-3904
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7736 S RIVERSIDE DR
-----------------------------------------------------
City | SAULT SAINTE MARIE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49783-8614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-871-3904
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 6801110260
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------