Provider Demographics
NPI:1306539507
Name:SERRANO, LINDSEY (LADC I)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:SERRANO
Suffix:
Gender:F
Credentials:LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 MONTEREY RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1454
Mailing Address - Country:US
Mailing Address - Phone:413-645-3717
Mailing Address - Fax:413-645-3451
Practice Address - Street 1:446 MONTEREY RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1454
Practice Address - Country:US
Practice Address - Phone:413-645-3717
Practice Address - Fax:413-645-3451
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22945101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)