Provider Demographics
NPI:1699437657
Name:SAUNDERS, LYNNE ELLIOTT
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:ELLIOTT
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14419 MATCHOTANK RD
Mailing Address - Street 2:
Mailing Address - City:ONANCOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417-3207
Mailing Address - Country:US
Mailing Address - Phone:757-607-6197
Mailing Address - Fax:
Practice Address - Street 1:14419 MATCHOTANK RD
Practice Address - Street 2:
Practice Address - City:ONANCOCK
Practice Address - State:VA
Practice Address - Zip Code:23417-3207
Practice Address - Country:US
Practice Address - Phone:757-607-6197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013554101YM0800X, 390200000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program