Organization
LINDSAY P. SOUTH, MA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE E. WEBB (OFFICE MANAGER)
(269) 303-3835
Entity
Organization
Contact information
Practice address
1591 W CENTRE AVE, SUITE 103, PORTAGE, MI 49024-6314
(269) 323-2553
Mailing address
1591 W. CENTRE AVENUE, SUITE 103, PORTAGE, MI 49024-5342
(269) 323-2553
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401005843
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942396205
INDIVIDUAL NPI
MI
Enumeration date
02/25/2016
Last updated
03/08/2016
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