Basic Information
| Provider Information | |||||||||
| NPI: | 1235290719 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINDO | ||||||||
| FirstName: | STACEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1619 BRALEY RD | ||||||||
| Address2: | #98 | ||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085096592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4 COURT ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | TAUNTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027803218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086819376 | ||||||||
| FaxNumber: | 5088842476 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2006 | ||||||||
| LastUpdateDate: | 05/12/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.