Provider Demographics
NPI:1225165830
Name:CHEVALIER, LYNN A (LPC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:CHEVALIER
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 1:2500 HALL AVE
Mailing Address - Street 2:SUITE A MARINETTE COUNTY HEALTH AND HUMAN SERVICES
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143
Mailing Address - Country:US
Mailing Address - Phone:715-732-7700
Mailing Address - Fax:715-732-7766
Practice Address - Street 1:2500 HALL AVE
Practice Address - Street 2:SUITE A MARINETTE COUNTY HEALTH AND HUMAN SERVICES
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143
Practice Address - Country:US
Practice Address - Phone:715-732-7700
Practice Address - Fax:715-732-7766
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1496125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39664100Medicaid