Basic Information
Provider Information
NPI: 1033732318
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAILE
FirstName: LINDSAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6060 N COLLEGE AVE
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462201907
CountryCode: US
TelephoneNumber: 3178155501
FaxNumber:  
Practice Location
Address1: 16414 SOUTHPARK DR
Address2:  
City: WESTFIELD
State: IN
PostalCode: 460748396
CountryCode: US
TelephoneNumber: 3178155501
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/21/2020
LastUpdateDate: 05/21/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/21/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


Home