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NPI 1285399360

NPI 1285399360 : LE'HANDRA LYNCH : CIRCLE PINES, MN

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General NPI Number Information
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    NPI Number           |    1285399360
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    Entity Type          |    Individual 
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    Provider Name        |    LE'HANDRA LYNCH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/03/2021
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    Last Update Date     |    03/05/2022
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Provider Practice Location Address
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    Address Line         |    3764 95TH AVE NE 
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    City                 |    CIRCLE PINES
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    State                |    MN
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    Zip                  |    55014-3849
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    Country              |    US
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    Telephone            |    651-415-6200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7848 NIAGARA LN N 
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    City                 |    MAPLE GROVE
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    State                |    MN
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    Zip                  |    55311-2122
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    Country              |    US
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    Telephone            |    763-607-9285
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    26612
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    License Number State |    MN
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