Provider Demographics
NPI:1538236625
Name:KRAHULEC, LYN (MED,MC,LPC)
Entity type:Individual
Prefix:MS
First Name:LYN
Middle Name:
Last Name:KRAHULEC
Suffix:
Gender:F
Credentials:MED,MC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8019 S 27TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-7063
Mailing Address - Country:US
Mailing Address - Phone:480-496-4020
Mailing Address - Fax:
Practice Address - Street 1:15215 S 48TH ST
Practice Address - Street 2:SUITE #150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-9142
Practice Address - Country:US
Practice Address - Phone:480-496-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC #0653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional