Provider Demographics
NPI:1588640205
Name:MORTON, LYNNA MEADOWS
Entity Type:Individual
Prefix:
First Name:LYNNA
Middle Name:MEADOWS
Last Name:MORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9845 WYNCHASE CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-5185
Mailing Address - Country:US
Mailing Address - Phone:334-322-3017
Mailing Address - Fax:
Practice Address - Street 1:7051 FAIN PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7805
Practice Address - Country:US
Practice Address - Phone:334-322-3017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1093A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional