Provider Demographics
NPI:1184633463
Name:BEDNARZ, LYNN MARIE
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
Last Name:BEDNARZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:BEDNARZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC, CADC
Mailing Address - Street 1:237 SOUTHWICK LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-2132
Mailing Address - Country:US
Mailing Address - Phone:847-951-1457
Mailing Address - Fax:847-330-1455
Practice Address - Street 1:237 SOUTHWICK LN
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-2132
Practice Address - Country:US
Practice Address - Phone:847-951-1457
Practice Address - Fax:847-330-1455
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635712OtherBLUE CROSS/BLUE SHIELD
IL247494OtherCOMPSYCH