Healthcare Provider Details

I. General information

NPI: 1124685938
Provider Name (Legal Business Name): GUY LYNCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 GRISWOLD ST
PORT HURON MI
48060-5847
US

IV. Provider business mailing address

529 M L KING AVE
FLINT MI
48502-2002
US

V. Phone/Fax

Practice location:
  • Phone: 810-238-0483
  • Fax: 810-239-5518
Mailing address:
  • Phone: 810-738-7226
  • Fax: 810-239-5518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: