Provider Demographics
NPI:1114078565
Name:SILVA-BREEN, LYNNE (MDIV, MA, LMFT)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:SILVA-BREEN
Suffix:
Gender:F
Credentials:MDIV, MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MCANDREWS RD W
Mailing Address - Street 2:SUITE 228
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4432
Mailing Address - Country:US
Mailing Address - Phone:612-735-2229
Mailing Address - Fax:
Practice Address - Street 1:1500 MCANDREWS RD W
Practice Address - Street 2:SUITE 228
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4432
Practice Address - Country:US
Practice Address - Phone:612-735-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
MN1680106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral