Basic Information
Provider Information
NPI: 1891234209
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARKOVSKY
FirstName: LYNDSIE
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 145 ATLANTA AVE
Address2:  
City: YOUNGSTOWN
State: OH
PostalCode: 445151721
CountryCode: US
TelephoneNumber: 7243332923
FaxNumber:  
Practice Location
Address1: 611 BELMONT AVE
Address2:  
City: YOUNGSTOWN
State: OH
PostalCode: 445021037
CountryCode: US
TelephoneNumber: 3307442991
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/17/2017
LastUpdateDate: 01/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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