Active NPI
Terry Lynne Wynne, LPC
- Professional Counselor
- Tucker, GA
National Provider Identifier
1790828085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1802
- Practice address
- 3863 Cedar Circle
Tucker, GA 30084 - Phone
- (770) 939-4367
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1802 | GA | Primary |
Addresses
Primary practice location
3863 Cedar Circle
Tucker, GA 30084
Mailing address
3863 Cedar Circle
Tucker, GA 30084
Phone (770) 939-4367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790828085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3863 CEDAR CIRCLE",
"city": "TUCKER",
"state": "GA",
"postal_code": "30084",
"telephone_number": "770-939-4367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3863 CEDAR CIRCLE",
"city": "TUCKER",
"state": "GA",
"postal_code": "30084",
"telephone_number": "770-939-4367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNNE",
"first_name": "TERRY",
"middle_name": "LYNNE",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "1802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.