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NPI Code Detail

MEDICARE: LINDSEY CISSE LMSW

MEDICARE: LINDSEY CISSE LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801096795MI

General Provider Information

NPI Number : 1043623283
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY CISSE LMSW
Provider Business Mailing Address
First Line : 6549 TOWN CENTER DR
Second Line : SUITE A
City : CLARKSTON
State : MI
Zip : 48346-4824
Country : US
Telephone Number : 248-620-6400
Fax Number : 248-620-6405
Provider Business Practice Location Address
First Line : 13305 REECK ROAD
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-3197
Country : US
Telephone Number : 734-225-2090
Fax Number : 734-225-2091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 08/31/2021

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Directions to “ LINDSEY CISSE LMSW” Practice Location

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