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NPI Code Detail

MEDICARE: LYNETTE M MCCORKLE LPC

MEDICARE: LYNETTE M MCCORKLE 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
1101YM0800XMental Health Counselor5471-125WI
2101YM0800XMental Health Counselor5471WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609115682
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNETTE M MCCORKLE LPC
Provider Business Mailing Address
First Line : 3144 VANZILE ROAD
Second Line :
City : CRANDON
State : WI
Zip : 54520-8149
Country : US
Telephone Number : 715-478-5180
Fax Number : 715-478-5904
Provider Business Practice Location Address
First Line : 3144 VANZILE ROAD
Second Line :
City : CRANDON
State : WI
Zip : 54520-8149
Country : US
Telephone Number : 715-478-5180
Fax Number : 715-478-5904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2013
Last Update Date : 06/30/2021

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54520-8149
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1851383525 — MR. GARY M PUSATERI MD
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1558379438 — MR. DAVID R KAUFMAN JR. RPH
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54520-8149
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Practice Fax:
1598954398 — DR. RICHARD ARTHUR BRANDNER M.D.
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3144 VANZILE RD
CRANDON, WI
54520-8149
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Practice Fax:
1073773677 — MRS. SUZETTE LINDA KATCHKO APNP
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3144 VANZILE RD
CRANDON, WI
54520-8149
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1467733576 — DR. STEPHANIE MARIE COONS DSW
Practice Location Address:
3144 VANZILE RD
CRANDON, WI
54520-8149
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Directions to “ LYNETTE M MCCORKLE LPC” Practice Location

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