Provider Demographics
NPI:1619206844
Name:HARRELL, LYNNELLE RENEE' (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LYNNELLE
Middle Name:RENEE'
Last Name:HARRELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 RICHARDSON RUN APT H
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-3919
Mailing Address - Country:US
Mailing Address - Phone:804-980-5763
Mailing Address - Fax:
Practice Address - Street 1:281 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 326
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2986
Practice Address - Country:US
Practice Address - Phone:757-490-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040071881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical