Provider Demographics
NPI:1306853494
Name:SCARBROUGH, LYNN ELLEN (MA, LPC, ACR)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ELLEN
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:MA, LPC, ACR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W JASPER DR STE 9
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-1328
Mailing Address - Country:US
Mailing Address - Phone:254-519-1144
Mailing Address - Fax:254-519-1155
Practice Address - Street 1:12416 HYMEADOW DR STE 207
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2283
Practice Address - Country:US
Practice Address - Phone:877-519-1144
Practice Address - Fax:254-519-1155
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19039101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health