Provider Demographics
NPI:1962694414
Name:WESTBERRY, LYNNE G (PHD)
Entity type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:G
Last Name:WESTBERRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1515 N UNIVERSITY DR
Mailing Address - Street 2:STE 203
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8919
Mailing Address - Country:US
Mailing Address - Phone:954-341-7778
Mailing Address - Fax:561-372-9234
Practice Address - Street 1:1500 N UNIVERSITY DR
Practice Address - Street 2:SUITE 202
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8914
Practice Address - Country:US
Practice Address - Phone:954-341-7778
Practice Address - Fax:954-341-7778
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY3771103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75800CMedicare PIN