Provider Demographics
NPI:1902694953
Name:LINDSEY, JONNIQUA
Entity type:Individual
Prefix:
First Name:JONNIQUA
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3489 SENNA XANDER APT 210
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-0025
Mailing Address - Country:US
Mailing Address - Phone:614-440-2828
Mailing Address - Fax:
Practice Address - Street 1:862 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3614
Practice Address - Country:US
Practice Address - Phone:614-440-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTJ383178251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health