Basic Information
Provider Information
NPI: 1629449780
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WORKS
FirstName: LINDSAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
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Mailing Information
Address1: 104 LILLIAN LN
Address2:  
City: SILVER SPRING
State: MD
PostalCode: 209041115
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 650 JOEL DR
Address2:  
City: FORT CAMPBELL
State: KY
PostalCode: 422235318
CountryCode: US
TelephoneNumber: 2707985179
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/15/2015
LastUpdateDate: 09/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 09/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084P0800X1635NEY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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