Provider Demographics
NPI:1598337701
Name:GELLNER, LYNDEN M (LMHCA)
Entity Type:Individual
Prefix:
First Name:LYNDEN
Middle Name:M
Last Name:GELLNER
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15109 45TH PL W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-2249
Mailing Address - Country:US
Mailing Address - Phone:425-344-5040
Mailing Address - Fax:
Practice Address - Street 1:3130 HOWE PL STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5641
Practice Address - Country:US
Practice Address - Phone:360-329-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61108223101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor