Provider Demographics
NPI:1578172508
Name:LYNNSHYMANLCSW,LLC
Entity Type:Organization
Organization Name:LYNNSHYMANLCSW,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-308-8738
Mailing Address - Street 1:2530 CRAWFORD AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4954
Mailing Address - Country:US
Mailing Address - Phone:847-308-8738
Mailing Address - Fax:
Practice Address - Street 1:2530 CRAWFORD AVE STE 115
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4954
Practice Address - Country:US
Practice Address - Phone:847-308-8738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)