Provider Demographics
NPI:1316916042
Name:RODGERS, LYNN SMITH (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:SMITH
Last Name:RODGERS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3560 DELAWARE ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3067
Mailing Address - Country:US
Mailing Address - Phone:409-899-3244
Mailing Address - Fax:409-898-3153
Practice Address - Street 1:3560 DELAWARE ST
Practice Address - Street 2:SUITE 107
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3067
Practice Address - Country:US
Practice Address - Phone:409-899-3244
Practice Address - Fax:409-898-3153
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional