Healthcare Provider Details

I. General information

NPI: 1336149822
Provider Name (Legal Business Name): LYN HERLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 6
WELLSBURG WV
26070-0006
US

IV. Provider business mailing address

PO BOX 6
WELLSBURG WV
26070-0006
US

V. Phone/Fax

Practice location:
  • Phone: 304-737-0622
  • Fax: 304-737-0622
Mailing address:
  • Phone: 304-737-0622
  • Fax: 304-737-0622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number909
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: