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NPI Code Detail

MEDICARE: AMY LYNN, LCPC, ATR

MEDICARE: AMY LYNN, LCPC, ATR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor180.006965IL

General Provider Information

NPI Number : 1003040890
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMY LYNN, LCPC, ATR
Provider Business Mailing Address
First Line : 2010 N SPAULDING AVE
Second Line : APT. 3
City : CHICAGO
State : IL
Zip : 60647-3736
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3020 N LINCOLN AVE
Second Line : FLOURISH STUDIOS
City : CHICAGO
State : IL
Zip : 60657-4208
Country : US
Telephone Number : 773-746-7429
Fax Number :
Authorized Official
Title or Position : DIRECTOR/THERAPIST
Name : AMY J LYNN
Credential : LCPC
Telephone Number : 773-746-7429
Provider Enumeration Date : 05/07/2009
Last Update Date : 05/07/2009

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