Provider Demographics
NPI:1568229334
Name:POLK, LINDSAY (PSYD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:POLK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14109 N 83RD AVE APT 329
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4779
Mailing Address - Country:US
Mailing Address - Phone:412-913-0730
Mailing Address - Fax:
Practice Address - Street 1:14109 N 83RD AVE APT 329
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4779
Practice Address - Country:US
Practice Address - Phone:412-913-0730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005964103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical