Provider Demographics
NPI:1588857338
Name:MACDONALD, LYNN M (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:M
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MRS
Other - First Name:LYNN
Other - Middle Name:M
Other - Last Name:BRIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:131 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-1762
Mailing Address - Country:US
Mailing Address - Phone:586-463-0123
Mailing Address - Fax:
Practice Address - Street 1:131 MARKET ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-1762
Practice Address - Country:US
Practice Address - Phone:586-463-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6803085171171M00000X
MI6401014776101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator