Provider Demographics
NPI:1477894210
Name:TOVAR, LYNN ZAGZEBSKI (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ZAGZEBSKI
Last Name:TOVAR
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:MARIE
Other - Last Name:ZAGZEBSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:136 E. CHAPEL HILL ST.
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701
Mailing Address - Country:US
Mailing Address - Phone:919-688-7101
Mailing Address - Fax:919-688-7102
Practice Address - Street 1:5509 CREEDMOOR RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6312
Practice Address - Country:US
Practice Address - Phone:919-573-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9526101YP2500X
NCA9526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional