Provider Demographics
NPI:1285839332
Name:LYNGE, AUDREY HOLMES (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:HOLMES
Last Name:LYNGE
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 1:901 BALMORAL DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6214
Mailing Address - Country:US
Mailing Address - Phone:336-250-1535
Mailing Address - Fax:
Practice Address - Street 1:3800 PARAMOUNT PARKWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6901
Practice Address - Country:US
Practice Address - Phone:919-674-2707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102809Medicaid
NC4592OtherLPC