Provider Demographics
NPI:1962384487
Name:LINDSAY, KURSTIN CHALISE
Entity type:Individual
Prefix:
First Name:KURSTIN
Middle Name:CHALISE
Last Name:LINDSAY
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 1:500 E 9 MILE RD APT 101
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1943
Mailing Address - Country:US
Mailing Address - Phone:313-346-3593
Mailing Address - Fax:
Practice Address - Street 1:18139 MCDOUGALL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1641
Practice Address - Country:US
Practice Address - Phone:313-346-3593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician