Healthcare Provider Details

I. General information

NPI: 1558790147
Provider Name (Legal Business Name): NATALIE E LYNN M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3662 W LINDA LN
CHANDLER AZ
85226-5902
US

IV. Provider business mailing address

3662 W LINDA LN
CHANDLER AZ
85226-5902
US

V. Phone/Fax

Practice location:
  • Phone: 480-231-5332
  • Fax:
Mailing address:
  • Phone: 480-231-5332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-10977
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: