Provider Demographics
NPI:1871904805
Name:LOCKENOUR, LYNNDI SUE (MED, LPCC)
Entity type:Individual
Prefix:
First Name:LYNNDI
Middle Name:SUE
Last Name:LOCKENOUR
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 NORTHSIDE AVE UNIT 7
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6968
Mailing Address - Country:US
Mailing Address - Phone:765-414-4450
Mailing Address - Fax:
Practice Address - Street 1:260 NORTHSIDE AVE UNIT 7
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6968
Practice Address - Country:US
Practice Address - Phone:765-414-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
KY166988101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY101YP2500XMedicaid