Provider Demographics
NPI:1558451732
Name:DELVAUX, LYNN (LMFT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:DELVAUX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:DELVAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CATC
Mailing Address - Street 1:5853 E DEBORAH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1311
Mailing Address - Country:US
Mailing Address - Phone:562-225-0667
Mailing Address - Fax:
Practice Address - Street 1:5853 E DEBORAH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1311
Practice Address - Country:US
Practice Address - Phone:562-225-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA020532101YA0400X
CAMFC 31693106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist