Provider Demographics
NPI:1497825301
Name:HEBERT, LYNETTE MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:MARIE
Last Name:HEBERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:LYNETTE
Other - Middle Name:HEBERT
Other - Last Name:BOUTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:860 W MOORHEAD CIR
Mailing Address - Street 2:#2D
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6166
Mailing Address - Country:US
Mailing Address - Phone:720-201-3456
Mailing Address - Fax:
Practice Address - Street 1:1405 FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2211
Practice Address - Country:US
Practice Address - Phone:303-504-1518
Practice Address - Fax:303-825-1711
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional