Provider Demographics
NPI:1154901338
Name:KNUDSEN, LINDSAY E (LMSW)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:E
Last Name:KNUDSEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GREENTREE DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769-1522
Mailing Address - Country:US
Mailing Address - Phone:631-827-9937
Mailing Address - Fax:
Practice Address - Street 1:7 GREENTREE DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1522
Practice Address - Country:US
Practice Address - Phone:631-827-9937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092053104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker