Provider Demographics
NPI:1861090037
Name:LINDSEY, BREONNA LYNNE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:BREONNA
Middle Name:LYNNE
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9104 NE 111TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-5810
Mailing Address - Country:US
Mailing Address - Phone:816-752-7813
Mailing Address - Fax:816-554-4360
Practice Address - Street 1:3211 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-2073
Practice Address - Country:US
Practice Address - Phone:816-554-4267
Practice Address - Fax:816-554-4360
Is Sole Proprietor?:No
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020022752104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker