=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922089143
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DALE R LINDSEY LPCC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20325 CENTER RIDGE RD SUITE 703
-----------------------------------------------------
City | ROCKY RIVER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44116-3572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-839-2273
-----------------------------------------------------
Fax | 216-896-0735
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 24242
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-0242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-839-2273
-----------------------------------------------------
Fax | 216-839-2273
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | E0002323
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------