Provider Demographics
NPI:1356038848
Name:KOPEC-MOHR, LYNETT MARIE (ATR, LCPC)
Entity type:Individual
Prefix:
First Name:LYNETT
Middle Name:MARIE
Last Name:KOPEC-MOHR
Suffix:
Gender:F
Credentials:ATR, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9036 MANSFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2441
Mailing Address - Country:US
Mailing Address - Phone:847-682-8386
Mailing Address - Fax:
Practice Address - Street 1:3534 LAKE AVE # 200
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1063
Practice Address - Country:US
Practice Address - Phone:547-386-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002646101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional