Healthcare Provider Details
I. General information
NPI: 1851228928
Provider Name (Legal Business Name): LYNNE STOLL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
145 BAY HARBOR BLVD
BRICK NJ
08723-7912
US
IV. Provider business mailing address
145 BAY HARBOR BLVD
BRICK NJ
08723-7912
US
V. Phone/Fax
- Phone: 732-300-2637
- Fax:
- Phone: 732-300-2637
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LYNNE
STOLL
Title or Position: LPC
Credential:
Phone: 732-300-2637