Basic Information
Provider Information
NPI: 1285097410
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYNN
FirstName: FRANCES
MiddleName: VIRGINIA
NamePrefix:  
NameSuffix:  
Credential: LPCC, ATR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6209 STORER AVE
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441025522
CountryCode: US
TelephoneNumber: 2166511450
FaxNumber: 2166514351
Practice Location
Address1: 6209 STORER AVE
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441025522
CountryCode: US
TelephoneNumber: 2166511450
FaxNumber: 2166514351
Other Information
ProviderEnumerationDate: 04/04/2016
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XE.0600460OHN Behavioral Health & Social Service ProvidersCounselorMental Health
101YP2500XE.0600460OHY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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