MEDICARE: MRS. LINDSAY HORTON LPC INTERN

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
1	101YP2500X	Professional Counselor	69236	TX

General Provider Information

NPI Number	:	1750622593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSAY HORTON LPC INTERN

Provider Business Mailing Address
First Line	:	4037 PARCHMAN ST
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8801
Country	:	US
Telephone Number	:	817-595-2520
Fax Number	:	817-284-8742

Provider Business Practice Location Address
First Line	:	4037 PARCHMAN ST
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-8801
Country	:	US
Telephone Number	:	817-595-2520
Fax Number	:	817-284-8742

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2013
Last Update Date	:	03/04/2013

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