Provider Demographics
NPI:1720136831
Name:BROWN, LYNDA JEAN (MS, LCPC)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:JEAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 S STATE ST
Mailing Address - Street 2:731
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2964
Mailing Address - Country:US
Mailing Address - Phone:312-567-0775
Mailing Address - Fax:312-567-0288
Practice Address - Street 1:415 W GOLF RD
Practice Address - Street 2:9
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3929
Practice Address - Country:US
Practice Address - Phone:847-952-9112
Practice Address - Fax:312-567-0288
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional