Provider Demographics
NPI:1588764757
Name:PARHAM, LYNDA MORRIS (PHD)
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:MORRIS
Last Name:PARHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 PLANO DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7816
Mailing Address - Country:US
Mailing Address - Phone:617-364-8888
Mailing Address - Fax:509-463-6385
Practice Address - Street 1:1330 BEACON ST
Practice Address - Street 2:STE 327
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3203
Practice Address - Country:US
Practice Address - Phone:617-358-1804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8235103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA8235OtherLICDPSYCHOLOGIST PROVIDER