Healthcare Provider Details

I. General information

NPI: 1134850761
Provider Name (Legal Business Name): ANNE LYNCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNE MCMAHON

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 MARKET ST FL 3
PHILADELPHIA PA
19139-4636
US

IV. Provider business mailing address

4601 MARKET ST FL 3
PHILADELPHIA PA
19139-4636
US

V. Phone/Fax

Practice location:
  • Phone: 215-878-3400
  • Fax:
Mailing address:
  • Phone: 215-878-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS020239
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: