Provider Demographics
NPI:1093735250
Name:ATKINSON, TRUDIE LYNNE (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:TRUDIE
Middle Name:LYNNE
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 W OLYMPIC ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-2771
Mailing Address - Country:US
Mailing Address - Phone:541-726-2769
Mailing Address - Fax:
Practice Address - Street 1:812 W OLYMPIC ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-2771
Practice Address - Country:US
Practice Address - Phone:541-726-2769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health