Provider Demographics
NPI:1366119794
Name:WOODALL, LINDSAY K
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:K
Last Name:WOODALL
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:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10272-0373
Mailing Address - Country:US
Mailing Address - Phone:704-806-4401
Mailing Address - Fax:
Practice Address - Street 1:445 S FIGUEROA ST STE 3100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-1635
Practice Address - Country:US
Practice Address - Phone:213-297-3921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health