Provider Demographics
NPI:1063230316
Name:HYNES, LYNN M (PHD, LMFTA)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:M
Last Name:HYNES
Suffix:
Gender:F
Credentials:PHD, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6524 CARROLLTON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1617
Mailing Address - Country:US
Mailing Address - Phone:317-496-0464
Mailing Address - Fax:
Practice Address - Street 1:6524 CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1617
Practice Address - Country:US
Practice Address - Phone:317-496-0464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN85000505A103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis