Provider Demographics
NPI:1588060719
Name:PINA, LYNNETTE INEZ (LPC)
Entity type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:INEZ
Last Name:PINA
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 1:202 E EARLL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2647
Mailing Address - Country:US
Mailing Address - Phone:602-808-2800
Mailing Address - Fax:602-808-2799
Practice Address - Street 1:40 E MITCHELL DR
Practice Address - Street 2:SUITE 100 & 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2330
Practice Address - Country:US
Practice Address - Phone:602-599-5564
Practice Address - Fax:602-248-7993
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional