MEDICARE: MS. LYNDA MARTIN LECLAIR LPC

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	101YP2500X	Professional Counselor	65374	TX

General Provider Information

NPI Number	:	1821350380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNDA MARTIN LECLAIR LPC

Provider Business Mailing Address
First Line	:	14918 EL GRANDE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-3223
Country	:	US
Telephone Number	:	346-813-2710
Fax Number	:

Provider Business Practice Location Address
First Line	:	14918 EL GRANDE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-3223
Country	:	US
Telephone Number	:	346-813-2710
Fax Number	:

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

Provider Enumeration Date	:	06/11/2012
Last Update Date	:	06/01/2016

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