Provider Demographics
NPI:1629139993
Name:SEXTON, LYNETTE M (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:M
Last Name:SEXTON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 EMERALD HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-8931
Mailing Address - Country:US
Mailing Address - Phone:360-918-3009
Mailing Address - Fax:
Practice Address - Street 1:625 S DIAMOND ST
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-3817
Practice Address - Country:US
Practice Address - Phone:360-918-3009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000084981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ7817Medicare UPIN