Basic Information
| Provider Information | |||||||||
| NPI: | 1477894210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOVAR | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | ZAGZEBSKI | ||||||||
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| Credential: | PHD, LPC | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ZAGZEBSKI | ||||||||
| OtherFirstName: | LYNN | ||||||||
| OtherMiddleName: | MARIE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 136 E. CHAPEL HILL ST. | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196887101 | ||||||||
| FaxNumber: | 9196887102 | ||||||||
| Practice Location | |||||||||
| Address1: | 5509 CREEDMOOR RD | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276126312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195736520 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2013 | ||||||||
| LastUpdateDate: | 06/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 9526 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | A9526 | NC | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.