Provider Demographics
NPI:1427314897
Name:GUYTON, LYNDA RUTH
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:RUTH
Last Name:GUYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LYNDA
Other - Middle Name:RUTH
Other - Last Name:GINES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:4907 MOSLEY RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-2649
Mailing Address - Country:US
Mailing Address - Phone:404-219-2013
Mailing Address - Fax:
Practice Address - Street 1:853 BATTLECREEK RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1919
Practice Address - Country:US
Practice Address - Phone:770-478-1099
Practice Address - Fax:770-478-8722
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001977101YP2500X
GA386429101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool