Provider Demographics
NPI:1821177809
Name:LYNN, KATHRYN A (LSCW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:A
Last Name:LYNN
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:18601 LYNDON B JOHNSON FWY
Mailing Address - Street 2:SUITE 701
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5600
Mailing Address - Country:US
Mailing Address - Phone:972-270-7565
Mailing Address - Fax:972-270-7776
Practice Address - Street 1:18601 LYNDON B JOHNSON FWY
Practice Address - Street 2:SUITE 701
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5600
Practice Address - Country:US
Practice Address - Phone:972-270-7565
Practice Address - Fax:972-270-7776
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS05940101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health