Provider Demographics
NPI:1417235391
Name:TYNDALL, LYNN SAULS (LCSW-P)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:SAULS
Last Name:TYNDALL
Suffix:
Gender:F
Credentials:LCSW-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 WOOTEN BLVD SW STE K
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4464
Mailing Address - Country:US
Mailing Address - Phone:252-291-0735
Mailing Address - Fax:252-291-2890
Practice Address - Street 1:2401 WOOTEN BLVD SW STE K
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893
Practice Address - Country:US
Practice Address - Phone:252-291-0735
Practice Address - Fax:252-291-2890
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPOO64971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical