Provider Demographics
NPI:1780632448
Name:RODGERS, LYNN (LCPC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:RODGERS
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 1:241 GOLF MILL CTR
Mailing Address - Street 2:SUITE 726
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1224
Mailing Address - Country:US
Mailing Address - Phone:847-824-7200
Mailing Address - Fax:847-824-7300
Practice Address - Street 1:241 GOLF MILL CTR
Practice Address - Street 2:SUITE 726
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1224
Practice Address - Country:US
Practice Address - Phone:847-824-7200
Practice Address - Fax:847-824-7300
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist