Provider Demographics
NPI:1730825316
Name:PONCE, LINDSAY (LCMHC-A)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:PONCE
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 MAITLAND CT
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-7236
Mailing Address - Country:US
Mailing Address - Phone:336-971-6296
Mailing Address - Fax:
Practice Address - Street 1:2235 LEWISVILLE CLEMMONS RD STE A
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9342
Practice Address - Country:US
Practice Address - Phone:336-568-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-07
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health