Provider Demographics
NPI:1679060982
Name:HAMILTON, LINDSAY (LP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LP
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:615 KINGSBURY ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1865
Mailing Address - Country:US
Mailing Address - Phone:567-218-0185
Mailing Address - Fax:419-930-6721
Practice Address - Street 1:3140 DUSTIN RD STE 1
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4341
Practice Address - Country:US
Practice Address - Phone:567-218-0185
Practice Address - Fax:419-930-6721
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301019452103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical