Individual provider Active NPI

Patricia Ray Lynne, MA, LPC, NCC, QMHP

  • Mental Health Counselor
  • Allegan, MI
National Provider Identifier
1497402424
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401223712 Issued in MI
Practice address
540 Jenner Dr
Allegan, MI 49010-1517
Phone
(269) 673-6617
NPI assigned
Mar 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401223712 MI Primary

Addresses

Primary practice location

540 Jenner Dr
Allegan, MI 49010-1517

Mailing address

540 Jenner Dr
Allegan, MI 49010-1517
Phone (269) 286-1383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208001517 MI Practitioner - Mental Health Counselor 9739522590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

540 Jenner Dr
Allegan, MI 49010-1517
Phone (269) 673-6617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Allegan County Community Mental Health Services CurrentSince Jan 1, 2024 Accepting new patients
Allegan County Community Mental Health Services CurrentSince Jan 1, 2024 Accepting new patients

Locations

540 Jenner Dr
Allegan, MI 49010
Phone (269) 673-6617

3285 122nd Ave
Allegan, MI 49010
Phone (269) 673-6617

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1497402424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517",
            "telephone_number": "269-286-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517",
            "telephone_number": "269-673-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNNE",
        "first_name": "PATRICIA",
        "middle_name": "RAY",
        "credential": "MA, LPC, NCC, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

Verify at the official NPI Registry.