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General NPI Number Information
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NPI Number | 1336994235
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Entity Type | Individual
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Provider Name | LYNDSY BOLTON MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 02/22/2026
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Provider Practice Location Address
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Address Line | 1010 E DUPONT RD
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City | FORT WAYNE
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State | IN
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Zip | 46825-1554
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Country | US
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Telephone | 260-471-8141
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Fax |
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Provider Business Mailing Address
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Address Line | 4308 N STATE ROAD 827
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City | FREMONT
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State | IN
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Zip | 46737-9778
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Country | US
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Telephone | 269-998-9890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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