Provider Demographics
NPI:1285252130
Name:ROBERTS, LINDSAY N (LSW)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:N
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 HURON ST
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44813-1208
Mailing Address - Country:US
Mailing Address - Phone:419-566-1224
Mailing Address - Fax:216-229-2605
Practice Address - Street 1:1025 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3427
Practice Address - Country:US
Practice Address - Phone:419-529-4602
Practice Address - Fax:216-229-2605
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.18029571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical