Healthcare Provider Details

I. General information

NPI: 1871667139
Provider Name (Legal Business Name): J. LYNN JAMES LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. LYNN JAMES

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 BRIERHILL DR
ISLAND LAKE IL
60042-9494
US

IV. Provider business mailing address

3621 BRIERHILL DR
ISLAND LAKE IL
60042-9494
US

V. Phone/Fax

Practice location:
  • Phone: 812-345-6941
  • Fax:
Mailing address:
  • Phone: 812-345-6941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number180.001634
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39001814A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: