Provider Demographics
NPI:1528355013
Name:WICK, LINDSAY C (MSED, MPE)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:C
Last Name:WICK
Suffix:
Gender:F
Credentials:MSED, MPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PECK RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1712
Mailing Address - Country:US
Mailing Address - Phone:610-357-8258
Mailing Address - Fax:
Practice Address - Street 1:401 PILGRIM LN
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-5000
Practice Address - Country:US
Practice Address - Phone:610-888-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)