Provider Demographics
NPI:1396809604
Name:TASHEA, LYN ALISON (LPC)
Entity type:Individual
Prefix:MS
First Name:LYN
Middle Name:ALISON
Last Name:TASHEA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110343
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-0343
Mailing Address - Country:US
Mailing Address - Phone:907-441-5382
Mailing Address - Fax:
Practice Address - Street 1:10115 MAIN TREE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-6931
Practice Address - Country:US
Practice Address - Phone:907-441-5382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK363101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional