Provider Demographics
NPI:1447643416
Name:LYNN, KATIE (LPC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:LYNN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 RIDGELAKE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4946
Mailing Address - Country:US
Mailing Address - Phone:504-388-3636
Mailing Address - Fax:
Practice Address - Street 1:2901 RIDGELAKE DR STE 106
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4946
Practice Address - Country:US
Practice Address - Phone:504-388-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-14
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4662101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
822922481OtherIRS