Basic Information
| Provider Information | |||||||||
| NPI: | 1063551398 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KROGH | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | BETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2522 W MACARTHUR BLVD UNIT H | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927047130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148513455 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21081 S WESTERN AVE STE 295 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905011707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105336600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 09/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS22469 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.