Provider Demographics
NPI:1689011793
Name:LYNN, BREANNA (LPCC)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:LYNN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6695 E PACIFIC COAST HWY STE 135
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4235
Mailing Address - Country:US
Mailing Address - Phone:562-431-5100
Mailing Address - Fax:
Practice Address - Street 1:6695 E PACIFIC COAST HWY STE 135
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4235
Practice Address - Country:US
Practice Address - Phone:562-431-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14950101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional