Provider Demographics
NPI:1598511198
Name:LINDSEY, JENNIFER LEIGH WARREN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH WARREN
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 SW CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1247
Mailing Address - Country:US
Mailing Address - Phone:541-261-4160
Mailing Address - Fax:
Practice Address - Street 1:61690 PETTIGREW RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2422
Practice Address - Country:US
Practice Address - Phone:541-617-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health