Basic Information
| Provider Information | |||||||||
| NPI: | 1316112691 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDSEY | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 S SHIELDS ST BLDG I | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805261827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702215255 | ||||||||
| FaxNumber: | 9702215206 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 S SHIELDS ST BLDG I | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702215255 | ||||||||
| FaxNumber: | 9702215206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2008 | ||||||||
| LastUpdateDate: | 10/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 411 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.