Provider Demographics
NPI:1376104703
Name:DELORENZO, LYNNE CABRA (LPC, MHSP, MED)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:CABRA
Last Name:DELORENZO
Suffix:
Gender:F
Credentials:LPC, MHSP, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 HARBOUR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-4033
Mailing Address - Country:US
Mailing Address - Phone:865-816-8407
Mailing Address - Fax:
Practice Address - Street 1:370 S LONG HOLLOW RD
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-8320
Practice Address - Country:US
Practice Address - Phone:865-816-8407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNLPC0000002298OtherTENNESSEE DEPT OF HEALTH: LICENSED PROFESSIONAL COUNSELOR