MEDICARE: LYN HERLEY LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	909	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	550583609057	OTHER	WV	BLUE CROSS/BLUE SHIELD
2	Y0909	OTHER	WV	HEALTH PLAN
3	733786000	OTHER	WV	MAGELLAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336149822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYN HERLEY LPC

Provider Business Mailing Address
First Line	:	PO BOX 6
Second Line	:
City	:	WELLSBURG
State	:	WV
Zip	:	26070-0006
Country	:	US
Telephone Number	:	304-737-0622
Fax Number	:	304-737-0622

Provider Business Practice Location Address
First Line	:	PO BOX 6
Second Line	:
City	:	WELLSBURG
State	:	WV
Zip	:	26070-0006
Country	:	US
Telephone Number	:	304-737-0622
Fax Number	:	304-737-0622

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	05/17/2024

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Directions to “ LYN HERLEY LPC” Practice Location

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