Provider Demographics
NPI:1720318942
Name:KONS, LYNN DELL (MFT)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:DELL
Last Name:KONS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5740 WINDMILL WAY
Mailing Address - Street 2:SUITE11
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-1379
Mailing Address - Country:US
Mailing Address - Phone:916-834-4059
Mailing Address - Fax:916-990-9964
Practice Address - Street 1:5740 WINDMILL WAY
Practice Address - Street 2:SUITE11
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1379
Practice Address - Country:US
Practice Address - Phone:916-834-4059
Practice Address - Fax:916-990-9964
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health