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NPI Code Detail

MEDICARE: LINDSEY E MARTIN LCSW

MEDICARE: LINDSEY E MARTIN LCSW
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 Worker149.020064IL

General Provider Information

NPI Number : 1629575238
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY E MARTIN LCSW
Provider Business Mailing Address
First Line : 4025 N SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2010
Country : US
Telephone Number : 773-388-1600
Fax Number : 773-388-1602
Provider Business Practice Location Address
First Line : 3245 N HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-3419
Country : US
Telephone Number : 773-388-1600
Fax Number : 773-388-1602
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2018
Last Update Date : 04/10/2018

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Directions to “ LINDSEY E MARTIN LCSW” Practice Location

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