Basic Information
| Provider Information | |||||||||
| NPI: | 1629362413 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEPIN | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | |||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 741 ORLEANS RD | ||||||||
| Address2: | |||||||||
| City: | NORTH CHATHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026501164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087379980 | ||||||||
| FaxNumber: | 5084331871 | ||||||||
| Practice Location | |||||||||
| Address1: | 728 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARWICH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026452750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087379980 | ||||||||
| FaxNumber: | 5084331871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2011 | ||||||||
| LastUpdateDate: | 07/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1300881 | 05 | MA | MEDICAID |