Provider Demographics
NPI:1104690957
Name:PAVELOCK, LINDSAY KAY
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:KAY
Last Name:PAVELOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:KAY
Other - Last Name:HADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6501 MEYER WAY APT 7293
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1508
Mailing Address - Country:US
Mailing Address - Phone:972-658-3142
Mailing Address - Fax:
Practice Address - Street 1:6501 MEYER WAY APT 7293
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1508
Practice Address - Country:US
Practice Address - Phone:972-658-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health