Healthcare Provider Details

I. General information

NPI: 1457725483
Provider Name (Legal Business Name): LYNETTE LEMING HOULE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNETTE LEMING LSW

II. Dates (important events)

Enumeration Date: 11/13/2015
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 US HIGHWAY 9
LANOKA HARBOR NJ
08734-1706
US

IV. Provider business mailing address

PO BOX 454
FORKED RIVER NJ
08731-0454
US

V. Phone/Fax

Practice location:
  • Phone: 609-242-0086
  • Fax:
Mailing address:
  • Phone: 732-300-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06694900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00424000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: