Provider Demographics
NPI:1225846868
Name:LINGAFELTER PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:LINGAFELTER PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LINGAFELTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:857-371-8291
Mailing Address - Street 1:82 MARLBOROUGH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:82 MARLBOROUGH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2020
Practice Address - Country:US
Practice Address - Phone:857-371-8291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health