Provider Demographics
NPI:1447793849
Name:MARTINDALE, MICHELE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:MARTINDALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SILSBEE ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1404
Mailing Address - Country:US
Mailing Address - Phone:781-599-0110
Mailing Address - Fax:781-586-8570
Practice Address - Street 1:8 SILSBEE ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1404
Practice Address - Country:US
Practice Address - Phone:781-599-0110
Practice Address - Fax:781-586-8570
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2183191041C0700X
MA1210571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical