Provider Demographics
NPI:1295221703
Name:HOWARD, LYNIESE
Entity Type:Individual
Prefix:
First Name:LYNIESE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 STRICKLAND RD
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-7635
Mailing Address - Country:US
Mailing Address - Phone:919-495-7825
Mailing Address - Fax:
Practice Address - Street 1:6602 KNIGHTDALE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6526
Practice Address - Country:US
Practice Address - Phone:919-747-5270
Practice Address - Fax:919-747-5271
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical