Provider Demographics
NPI:1447762133
Name:MCCOMMONS, LYNSEY ERIN (CRC, PLPC)
Entity Type:Individual
Prefix:
First Name:LYNSEY
Middle Name:ERIN
Last Name:MCCOMMONS
Suffix:
Gender:F
Credentials:CRC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3646 S CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5202
Mailing Address - Country:US
Mailing Address - Phone:417-597-4309
Mailing Address - Fax:417-763-3308
Practice Address - Street 1:3646 S CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5202
Practice Address - Country:US
Practice Address - Phone:417-597-4309
Practice Address - Fax:417-763-3308
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017038640101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health