Provider Demographics
NPI:1982754883
Name:GARDNER, LYNN MERIE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MERIE
Last Name:GARDNER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 MCCLELLAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CLANCY
Mailing Address - State:MT
Mailing Address - Zip Code:59634-9652
Mailing Address - Country:US
Mailing Address - Phone:406-443-0698
Mailing Address - Fax:
Practice Address - Street 1:25 S EWING ST STE 402A
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5753
Practice Address - Country:US
Practice Address - Phone:406-495-1936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT768101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health