Provider Demographics
NPI:1639217557
Name:CLAUSEN, LYNETTE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11275 W 167TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5816
Mailing Address - Country:US
Mailing Address - Phone:708-349-0814
Mailing Address - Fax:
Practice Address - Street 1:11275 W 167TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5816
Practice Address - Country:US
Practice Address - Phone:708-349-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180001003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional