Provider Demographics
NPI:1649638602
Name:LINDSAY, JAY SAGONA (PHD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:SAGONA
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 MCCASLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2941
Mailing Address - Country:US
Mailing Address - Phone:303-545-9828
Mailing Address - Fax:720-874-9644
Practice Address - Street 1:357 MCCASLIN BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2941
Practice Address - Country:US
Practice Address - Phone:303-545-9828
Practice Address - Fax:720-874-9644
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO675103TC0700X
CO045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist