Provider Demographics
NPI:1134246333
Name:JEFFERSON, LYNN (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 RIDGEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4270
Mailing Address - Country:US
Mailing Address - Phone:609-346-7167
Mailing Address - Fax:
Practice Address - Street 1:400 N CHURCH ST STE 100
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1771
Practice Address - Country:US
Practice Address - Phone:609-346-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00039000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional