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NPI Code Detail

MEDICARE: DR. AMI LYNCH MSW, PHD, LCSW LICSW

MEDICARE:  DR. AMI  LYNCH  MSW, PHD, LCSW LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker089.0135501TELEVT
21041C0700XClinical Social Worker0904015753VA
31041C0700XClinical Social WorkerLC200002873DC
41041C0700XClinical Social WorkerC017080NC
51041C0700XClinical Social WorkerTH00946705WV
61041C0700XClinical Social Worker0906011427VA

General Provider Information

NPI Number : 1578221222
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMI LYNCH MSW, PHD, LCSW LICSW
Provider Business Mailing Address
First Line : 1530 WILSON BLVD STE 650
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1530 WILSON BLVD STE 650
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2455
Country : US
Telephone Number : 202-780-9302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2021
Last Update Date : 04/28/2024

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