Basic Information
| Provider Information | |||||||||
| NPI: | 1427526029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WETHERBEE | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | SEAY | ||||||||
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| Credential: | MSW,LCSWA, LCASA, QP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3325 DURHAM CHAPEL HILL BLVD | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277076235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3369331901 | ||||||||
| FaxNumber: | 9848880913 | ||||||||
| Practice Location | |||||||||
| Address1: | 3325 DURHAM CHAPEL HILL BLVD | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277076235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193380939 | ||||||||
| FaxNumber: | 9848880913 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2018 | ||||||||
| LastUpdateDate: | 11/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | LCAS-24715 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | P012629 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.