Provider Demographics
NPI:1578904264
Name:STANDEVEN, LINDSAY ROTHENBERG (MD)
Entity type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:ROTHENBERG
Last Name:STANDEVEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:ROTHENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 WYNDHURST AVE STE 308C
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2489
Mailing Address - Country:US
Mailing Address - Phone:443-203-8985
Mailing Address - Fax:689-202-8394
Practice Address - Street 1:600 WYNDHURST AVE STE 308C
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2489
Practice Address - Country:US
Practice Address - Phone:443-203-8985
Practice Address - Fax:689-202-8394
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD821942084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program