Provider Demographics
NPI:1902153919
Name:GREEN, LINDSEY ANN (LPCC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:GREEN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 OLD MUNFORDVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CAVE CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42127-9392
Mailing Address - Country:US
Mailing Address - Phone:270-791-8322
Mailing Address - Fax:270-678-7837
Practice Address - Street 1:9940 ALVATON RD
Practice Address - Street 2:
Practice Address - City:ALVATON
Practice Address - State:KY
Practice Address - Zip Code:42122-9657
Practice Address - Country:US
Practice Address - Phone:270-791-8322
Practice Address - Fax:270-678-7837
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1110101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health