Provider Demographics
NPI:1336226737
Name:JAMES, LYNN S (MA LPC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:S
Last Name:JAMES
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:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-0506
Mailing Address - Country:US
Mailing Address - Phone:573-756-3330
Mailing Address - Fax:573-747-3023
Practice Address - Street 1:506 NORTH ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-3213
Practice Address - Country:US
Practice Address - Phone:573-756-3330
Practice Address - Fax:573-747-3023
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001502101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor