Provider Demographics
NPI:1780757344
Name:HOWARD, LYNELL ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:LYNELL
Middle Name:ANN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 SURREY HILL CIR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6034
Mailing Address - Country:US
Mailing Address - Phone:678-225-5854
Mailing Address - Fax:
Practice Address - Street 1:2420 EASTGATE PL
Practice Address - Street 2:SUITE G-400
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6199
Practice Address - Country:US
Practice Address - Phone:678-225-5854
Practice Address - Fax:678-829-0526
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004120101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA732281405AMedicaid