Healthcare Provider Details

I. General information

NPI: 1205073731
Provider Name (Legal Business Name): LYNSEY VANGHEL FLAHERTY MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 CHAPEL HILL RD
SPRING LAKE NC
28390-2140
US

IV. Provider business mailing address

88 COTTSWOLD LN
SPRING LAKE NC
28390-7053
US

V. Phone/Fax

Practice location:
  • Phone: 910-916-7881
  • Fax: 910-436-5343
Mailing address:
  • Phone: 203-258-2571
  • Fax: 910-436-5343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006317
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: