Provider Demographics
NPI:1861614703
Name:HARGROVE, LYNN M (PSYD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:M
Last Name:HARGROVE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 NORTH DIXIE HIGHWAY
Mailing Address - Street 2:PALM BEACH COUNTY COURTHOUSE SUITE 4.1100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:561-355-2108
Mailing Address - Fax:561-355-4004
Practice Address - Street 1:205 NORTH DIXIE HIGHWAY
Practice Address - Street 2:PALM BEACH COUNTY COURTHOUSE SUITE 4.1100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-355-2108
Practice Address - Fax:561-355-4004
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6874103T00000X
103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic