MEDICARE: DR. LYN EVELYN MURICE CLAWSON PHD

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
1	101YM0800X	Mental Health Counselor	MH1357	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2246008	OTHER		COMPSYCH
2	000520096	OTHER		UNITED HEALTH CARE
3	337532	OTHER		AVMED
4	017880	OTHER		PSYCHARE LLC
5	0005319277	OTHER	FL	AETNA
6	Z1512	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1366622151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYN EVELYN MURICE CLAWSON PHD

Provider Business Mailing Address
First Line	:	PO BOX 12966
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32604
Country	:	US
Telephone Number	:	352-359-0340
Fax Number	:	352-264-3292

Provider Business Practice Location Address
First Line	:	1103 SW 2ND AVE RM 3
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32601-6116
Country	:	US
Telephone Number	:	352-359-0340
Fax Number	:	352-378-0028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	12/13/2016

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