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General NPI Number Information
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NPI Number | 1336700236
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Entity Type | Individual
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Provider Name | JASON MATTHEW LYNCH MS, LMHC, LCAC, ADS
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Gender | Male
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Dates
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Enumeration Date | 06/22/2019
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 23 S 8TH ST STE 300
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City | NOBLESVILLE
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State | IN
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Zip | 46060-2633
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Country | US
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Telephone | 317-754-0808
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Fax | 317-983-7383
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Provider Business Mailing Address
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Address Line | 5716 DURHAM CASTLE CT APT 114
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-5629
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Country | US
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Telephone | 314-306-4401
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 39004109A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 87001667A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 88000903A
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License Number State | IN
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