Provider Demographics
NPI:1215457031
Name:STOCKTON, LYNNDSEE MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:LYNNDSEE
Middle Name:MARIE
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LYNNDSEE
Other - Middle Name:MARIE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY RDG STE 625
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY RDG STE 625
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3685
Practice Address - Country:US
Practice Address - Phone:864-467-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC109351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical