Provider Demographics
NPI:1902354525
Name:HARNACK, LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:HARNACK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:MATUZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 E SIMPSON ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2394
Mailing Address - Country:US
Mailing Address - Phone:303-828-6509
Mailing Address - Fax:
Practice Address - Street 1:400 E SIMPSON ST
Practice Address - Street 2:SUITE 108
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2394
Practice Address - Country:US
Practice Address - Phone:303-828-6509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012946101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional