Healthcare Provider Details

I. General information

NPI: 1588640205
Provider Name (Legal Business Name): LYNNA MORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 GRAND AVE SW
FORT PAYNE AL
35967-1917
US

IV. Provider business mailing address

215 GRAND AVE SW
FORT PAYNE AL
35967-1917
US

V. Phone/Fax

Practice location:
  • Phone: 256-254-9628
  • Fax: 256-991-0424
Mailing address:
  • Phone: 256-254-9628
  • Fax: 256-991-0424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC02547
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: