Healthcare Provider Details

I. General information

NPI: 1548648256
Provider Name (Legal Business Name): LYNN PARKER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 DOROTHY CT
CHESAPEAKE VA
23323-6688
US

IV. Provider business mailing address

1245G CEDAR RD # 223
CHESAPEAKE VA
23322-7103
US

V. Phone/Fax

Practice location:
  • Phone: 757-636-8080
  • Fax:
Mailing address:
  • Phone: 757-524-0461
  • Fax: 757-800-8336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701006050
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: