Provider Demographics
NPI:1124139415
Name:HERRICK, E. LYNN (LMFT, LP)
Entity type:Individual
Prefix:
First Name:E.
Middle Name:LYNN
Last Name:HERRICK
Suffix:
Gender:M
Credentials:LMFT, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 E LUVERNE ST
Mailing Address - Street 2:PO BOX 686
Mailing Address - City:LUVERNE
Mailing Address - State:MN
Mailing Address - Zip Code:56156-1610
Mailing Address - Country:US
Mailing Address - Phone:507-283-9511
Mailing Address - Fax:507-283-9514
Practice Address - Street 1:1024 7TH AVE
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2287
Practice Address - Country:US
Practice Address - Phone:507-376-4141
Practice Address - Fax:507-376-4494
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2227103TC0700X
MN220106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist