Provider Demographics
NPI:1528300159
Name:DEGROOT, LINDSAY (LCPC)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:DEGROOT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:LINDSAY
Other - Middle Name:ERIN
Other - Last Name:LEADBETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:PO BOX 1661
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:MT
Mailing Address - Zip Code:59729-1661
Mailing Address - Country:US
Mailing Address - Phone:406-570-2692
Mailing Address - Fax:
Practice Address - Street 1:1 STEAMBATH DR
Practice Address - Street 2:SUITE B
Practice Address - City:ENNIS
Practice Address - State:MT
Practice Address - Zip Code:59729
Practice Address - Country:US
Practice Address - Phone:406-570-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10413208101YM0800X
WAMHC.LH.60725489101YP2500X
MT38929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health