1285987305 NPI number — MR. LYNN OWENS LMHC

Table of content: MR. LYNN OWENS LMHC (NPI 1285987305)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285987305 NPI number — MR. LYNN OWENS LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OWENS
Provider First Name:
LYNN
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285987305
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 E. TWIGGS ST STE 1000
Provider Second Line Business Mailing Address:
PMB 91825
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33602-3931
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-795-1944
Provider Business Mailing Address Fax Number:
509-834-7286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1355 COLUMBIA PARK TRL STE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99352-4770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-460-8006
Provider Business Practice Location Address Fax Number:
509-834-7286
Provider Enumeration Date:
10/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH60515878 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2039983 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com