Provider Demographics
NPI:1710647904
Name:LYNTON, EDDY (PHD, LCDC)
Entity Type:Individual
Prefix:
First Name:EDDY
Middle Name:
Last Name:LYNTON
Suffix:
Gender:M
Credentials:PHD, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 E OAK ST STE 900
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4206
Mailing Address - Country:US
Mailing Address - Phone:940-453-4094
Mailing Address - Fax:
Practice Address - Street 1:109 E OAK ST STE 900
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4206
Practice Address - Country:US
Practice Address - Phone:940-453-4094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14079101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)