=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386646982
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOANN M LYNN M.S.W.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | NATIONAL NAVAL MEDICAL CENTER, SOCIAL WORK 8901 WISCONSIN AVE
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20889-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-295-5921
-----------------------------------------------------
Fax | 301-295-0003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4100 W ST NW #403
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20007-4029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-337-2407
-----------------------------------------------------
Fax | 301-295-0003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0904003248
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------