| Doctor Name: | LYNETTE M MCCORKLE |
| NPI Number: | 1609115682 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 5471-125 |
| Business Practice Address: | 8201 Mish Ko Swen Dr Crandon, WI - 545208631 |
| Business Phone Number: | 7154784300 |
| Business Fax Number: | |
| Mailing Address: | Po Box 396, 8201 Mish Ko Swen Drive CRANDON |
| State: | WI |
| Postal Code: | 545200396 |
| Phone Number: | 7154784300 |
| Fax Number: | |
| NPI Enumeration Date: | 02/11/2013 |
| NPI Last Update Date: | 05/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 5471-125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |