Provider Demographics
NPI:1811870082
Name:VITO, LYNDSEY
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:VITO
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 1:212 DUBOIS RD
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1225
Mailing Address - Country:US
Mailing Address - Phone:856-689-3066
Mailing Address - Fax:
Practice Address - Street 1:420 SECOND AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-1045
Practice Address - Country:US
Practice Address - Phone:609-602-0165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ15BC00209300103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst