Provider Demographics
NPI:1376681460
Name:CERTAIN, LYNNE ANNE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:ANNE
Last Name:CERTAIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2101
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-0900
Mailing Address - Country:US
Mailing Address - Phone:208-448-4855
Mailing Address - Fax:208-448-2467
Practice Address - Street 1:301 ALBENI RD., SUITE C
Practice Address - Street 2:
Practice Address - City:PRIEST RIVER
Practice Address - State:ID
Practice Address - Zip Code:83856
Practice Address - Country:US
Practice Address - Phone:208-448-4855
Practice Address - Fax:208-448-2467
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-139101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health