Healthcare Provider Details

I. General information

NPI: 1497567424
Provider Name (Legal Business Name): VICTORIA ASHANTI LYNCH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 MAROSE DR
PITTSBURGH PA
15235-4341
US

IV. Provider business mailing address

212 MAROSE DR
PENN HILLS PA
15235-4341
US

V. Phone/Fax

Practice location:
  • Phone: 412-607-2096
  • Fax:
Mailing address:
  • Phone: 412-607-2096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW027654
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: