MEDICARE: VANENCIA LYNCH LPC

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
1	106S00000X	Behavior Technician
2	101YP2500X	Professional Counselor	79540	TX

General Provider Information

NPI Number	:	1609327782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANENCIA LYNCH LPC

Provider Business Mailing Address
First Line	:	3616 RICHMOND AVE APT 2326
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-3643
Country	:	US
Telephone Number	:	281-408-9376
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 BERRY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77022-3209
Country	:	US
Telephone Number	:	281-408-9376
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	10/20/2023

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