Provider Demographics
NPI:1952615619
Name:MCARTHUR, LYN NICOLE (PHD)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:NICOLE
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LYN
Other - Middle Name:NICOLE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:500 S 11TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-4880
Mailing Address - Country:US
Mailing Address - Phone:202-232-7862
Mailing Address - Fax:208-232-7869
Practice Address - Street 1:1001 N 7TH AVE STE 135
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-5790
Practice Address - Country:US
Practice Address - Phone:208-425-2489
Practice Address - Fax:833-908-2327
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-202611103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist