Provider Demographics
NPI:1508836362
Name:FLAHARDY, LYN E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LYN
Middle Name:E
Last Name:FLAHARDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20791 MISTY WATERS PT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62974-1884
Mailing Address - Country:US
Mailing Address - Phone:618-982-2567
Mailing Address - Fax:
Practice Address - Street 1:109 LOU ANN DR
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-3733
Practice Address - Country:US
Practice Address - Phone:618-988-1330
Practice Address - Fax:618-988-8321
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040038121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical