Provider Demographics
NPI:1770331407
Name:DIETZ, LYNSIE NICOLE (LPC)
Entity type:Individual
Prefix:
First Name:LYNSIE
Middle Name:NICOLE
Last Name:DIETZ
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 KINNEAR RD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1489
Mailing Address - Country:US
Mailing Address - Phone:614-687-0068
Mailing Address - Fax:
Practice Address - Street 1:807 KINNEAR RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1489
Practice Address - Country:US
Practice Address - Phone:614-687-0068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2405936-TRNE101Y00000X, 101YP2500X
OHC.2506942101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty