Provider Demographics
NPI:1669622460
Name:MARY K. LYNDELL, PSY.D., P. C.
Entity type:Organization
Organization Name:MARY K. LYNDELL, PSY.D., P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LYNDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:816-318-3537
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-0365
Mailing Address - Country:US
Mailing Address - Phone:816-318-3537
Mailing Address - Fax:816-318-3538
Practice Address - Street 1:210 E NORTH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-9908
Practice Address - Country:US
Practice Address - Phone:816-318-3537
Practice Address - Fax:816-318-3538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01873103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty