Provider Demographics
NPI:1447880828
Name:KESTLER, LINDSAY MARGARET (MA, LBA)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MARGARET
Last Name:KESTLER
Suffix:
Gender:F
Credentials:MA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 WASHINGTON HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-1325
Mailing Address - Country:US
Mailing Address - Phone:631-637-5397
Mailing Address - Fax:
Practice Address - Street 1:79 WASHINGTON HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-1325
Practice Address - Country:US
Practice Address - Phone:631-637-5397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001801103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst