Provider Demographics
NPI:1093055725
Name:LINDSEY, KRISTA LYNN (LCAC, MS)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:LYNN
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:LCAC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-3734
Mailing Address - Country:US
Mailing Address - Phone:316-264-8800
Mailing Address - Fax:
Practice Address - Street 1:333 S GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-1819
Practice Address - Country:US
Practice Address - Phone:316-264-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-16
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS385101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)