=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255477543
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSEY DEVIN LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2007
-----------------------------------------------------
Last Update Date | 10/10/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 945 MAIN ST SUITE 211
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06040-6064
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-471-1125
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32 DAVID DR
-----------------------------------------------------
City | COVENTRY
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06238-1320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-471-1125
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 1246
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------