Provider Demographics
NPI:1841416310
Name:VAN METER, LYNETTE W (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:W
Last Name:VAN METER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13300 S ROUTE 59
Mailing Address - Street 2:SUITE B7
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-9847
Mailing Address - Country:US
Mailing Address - Phone:630-728-5393
Mailing Address - Fax:815-577-2785
Practice Address - Street 1:13300 S ROUTE 59
Practice Address - Street 2:SUITE B7
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-9847
Practice Address - Country:US
Practice Address - Phone:630-728-5393
Practice Address - Fax:815-577-2785
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932120OtherBLUE CROSS BLUE SHIELD