Provider Demographics
NPI:1174646459
Name:HAMSEN, LYNN MARIE (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:LYNN MARIE
Middle Name:
Last Name:HAMSEN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 WEDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-6271
Mailing Address - Country:US
Mailing Address - Phone:847-659-1770
Mailing Address - Fax:847-659-1772
Practice Address - Street 1:241 WEDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-6271
Practice Address - Country:US
Practice Address - Phone:847-659-1770
Practice Address - Fax:847-659-1772
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15079CMADC101YA0400X
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health