Provider Demographics
NPI:1104156702
Name:WERT, LINDSEY NICOLE (MFT)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:NICOLE
Last Name:WERT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SUNNYHILLS DR
Mailing Address - Street 2:BLDG. 5
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1909
Mailing Address - Country:US
Mailing Address - Phone:530-209-9107
Mailing Address - Fax:
Practice Address - Street 1:360 NORTH DUTTON AVENUE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-2065
Practice Address - Country:US
Practice Address - Phone:530-209-9107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81233106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist