Provider Demographics
NPI:1336410943
Name:AMASON, LINDSEY BETH (BHRS)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:BETH
Last Name:AMASON
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17882 W GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-1013
Mailing Address - Country:US
Mailing Address - Phone:918-348-5629
Mailing Address - Fax:
Practice Address - Street 1:17882 W GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-1013
Practice Address - Country:US
Practice Address - Phone:918-348-5629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKD083035220101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor