Provider Demographics
NPI:1093209868
Name:CRIDER, LYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:CRIDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8833 CINCINNATI DAYTON RD STE 105
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-7106
Mailing Address - Country:US
Mailing Address - Phone:513-818-3148
Mailing Address - Fax:
Practice Address - Street 1:8833 CINCINNATI DAYTON RD STE 105
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-7106
Practice Address - Country:US
Practice Address - Phone:513-759-9744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801225101YP2500X
OHE.2001908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty