Individual
MRS. LYNN R HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC-S
Contact information
Practice address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Mailing address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E.0500519-SUPV
OH
101YP2500X
Professional Counselor
Primary
E.0500519-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
MEDICAID CHEMICAL DEPENDCY
OH
01
—
0074946
MEDICAID
OH
01
—
01-0693
CARF CERTIFICATION
OH
01
—
H130910
MEDICARE GROUP PTAN
OH
Enumeration date
06/09/2009
Last updated
01/08/2024
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