Provider Demographics
NPI:1609977180
Name:ARMSTRONG, J LYNNE (EDD CLINICAL COUNSEL)
Entity Type:Individual
Prefix:DR
First Name:J LYNNE
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:EDD CLINICAL COUNSEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 PARK TEN BLVD
Mailing Address - Street 2:103N
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213
Mailing Address - Country:US
Mailing Address - Phone:210-735-2740
Mailing Address - Fax:210-735-3572
Practice Address - Street 1:6800 PARK TEN BLVD
Practice Address - Street 2:103N
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213
Practice Address - Country:US
Practice Address - Phone:210-735-2740
Practice Address - Fax:210-735-3572
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX561101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX026197601Medicaid