Healthcare Provider Details

I. General information

NPI: 1669306247
Provider Name (Legal Business Name): LYNN MCGUIRE RAJ LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 TOWNCENTER DR
CLEMMONS NC
27012-9376
US

IV. Provider business mailing address

6255 TOWNCENTER DR
CLEMMONS NC
27012-9376
US

V. Phone/Fax

Practice location:
  • Phone: 336-484-1222
  • Fax:
Mailing address:
  • Phone: 336-484-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP022963
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: