Provider Demographics
NPI:1366622151
Name:CLAWSON, LYN EVELYN MURICE (PHD)
Entity type:Individual
Prefix:DR
First Name:LYN EVELYN
Middle Name:MURICE
Last Name:CLAWSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LYN
Other - Middle Name:E
Other - Last Name:CLAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PH D
Mailing Address - Street 1:PO BOX 12966
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32604
Mailing Address - Country:US
Mailing Address - Phone:352-359-0340
Mailing Address - Fax:352-264-3292
Practice Address - Street 1:1103 SW 2ND AVE RM 3
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6116
Practice Address - Country:US
Practice Address - Phone:352-359-0340
Practice Address - Fax:352-378-0028
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2246008OtherCOMPSYCH
000520096OtherUNITED HEALTH CARE
337532OtherAVMED
017880OtherPSYCHARE LLC
FL0005319277OtherAETNA
FLZ1512OtherBCBS