Provider Demographics
NPI:1407509581
Name:WATT, LYNDA JEANETTE (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:JEANETTE
Last Name:WATT
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11429 W MISSION POINTE DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-8237
Mailing Address - Country:US
Mailing Address - Phone:208-850-0070
Mailing Address - Fax:
Practice Address - Street 1:11429 W MISSION POINTE DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-8237
Practice Address - Country:US
Practice Address - Phone:208-850-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-8033101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health