Provider Demographics
NPI:1184847782
Name:NEGRETE, LYNN H (LPC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:H
Last Name:NEGRETE
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:PO BOX 2535
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-7535
Mailing Address - Country:US
Mailing Address - Phone:903-603-2107
Mailing Address - Fax:903-675-9577
Practice Address - Street 1:700 S PALESTINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3325
Practice Address - Country:US
Practice Address - Phone:903-675-9570
Practice Address - Fax:903-675-9577
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1572101YP2500X
TX65342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR195164Medicaid
TX289950201Medicaid
OR123190Medicaid