Provider Demographics
NPI:1619068905
Name:MCBRIDE, LYNN E (LPC, LMFT,CSAC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:E
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:LPC, LMFT,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ELON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-2536
Mailing Address - Country:US
Mailing Address - Phone:434-455-2480
Mailing Address - Fax:434-455-2487
Practice Address - Street 1:320 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-2306
Practice Address - Country:US
Practice Address - Phone:434-947-5967
Practice Address - Fax:434-947-5971
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710000995101YA0400X
VA0701002425101YP2500X
VA0717000590106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945441Medicaid
VA331950OtherANTHEM BLUE SHIELD
VAO88267OtherSENTARA