Provider Demographics
NPI:1942516422
Name:LYKINS COUNSELING CLINIC
Entity type:Organization
Organization Name:LYKINS COUNSELING CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DEEANN
Authorized Official - Last Name:ARTHUR-LYKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, HSPP
Authorized Official - Phone:765-282-7150
Mailing Address - Street 1:4221 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-1015
Mailing Address - Country:US
Mailing Address - Phone:765-282-7150
Mailing Address - Fax:765-282-9166
Practice Address - Street 1:4221 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-1015
Practice Address - Country:US
Practice Address - Phone:765-282-7150
Practice Address - Fax:765-282-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040977103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty