Provider Demographics
NPI:1144586975
Name:CONNELL, LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:CONNELL
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 1:117 B ST SW
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-6401
Mailing Address - Country:US
Mailing Address - Phone:580-226-3750
Mailing Address - Fax:580-226-6470
Practice Address - Street 1:117 B ST SW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6401
Practice Address - Country:US
Practice Address - Phone:580-226-3750
Practice Address - Fax:580-226-6470
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health