Healthcare Provider Details

I. General information

NPI: 1871904805
Provider Name (Legal Business Name): LYNNDI SUE LOCKENOUR M.ED., LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 NORTHSIDE AVE UNIT 7
SHEPHERDSVILLE KY
40165-6968
US

IV. Provider business mailing address

260 NORTHSIDE AVE UNIT 7
SHEPHERDSVILLE KY
40165-6968
US

V. Phone/Fax

Practice location:
  • Phone: 765-414-4450
  • Fax:
Mailing address:
  • Phone: 765-414-4450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number166988
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: