Provider Demographics
NPI:1336149822
Name:HERLEY, LYN (LPC)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:
Last Name:HERLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:WELLSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26070-0006
Mailing Address - Country:US
Mailing Address - Phone:304-737-0622
Mailing Address - Fax:304-737-0622
Practice Address - Street 1:PO BOX 6
Practice Address - Street 2:
Practice Address - City:WELLSBURG
Practice Address - State:WV
Practice Address - Zip Code:26070-0006
Practice Address - Country:US
Practice Address - Phone:304-737-0622
Practice Address - Fax:304-737-0622
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV550583609057OtherBLUE CROSS/BLUE SHIELD
WVY0909OtherHEALTH PLAN
WV733786000OtherMAGELLAN
WV0023528001Medicaid