Basic Information
Provider Information
NPI: 1710461991
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEESE
FirstName: LINDSAY
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: CDCA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 615 ELSINORE PL STE 200
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452021459
CountryCode: US
TelephoneNumber: 5138347063
FaxNumber: 5138731567
Practice Location
Address1: 3545 LINCOLN WAY E STE B
Address2:  
City: MASSILLON
State: OH
PostalCode: 446468624
CountryCode: US
TelephoneNumber: 5138347063
FaxNumber: 5138731567
Other Information
ProviderEnumerationDate: 09/24/2018
LastUpdateDate: 06/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XCDCA.171685OHY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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