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General NPI Number Information
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NPI Number | 1417920737
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Entity Type | Individual
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Provider Name | JOHN LYNCH LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 99 BEAUVOIR AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3533
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Country | US
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Telephone | 908-522-2857
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 23831
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City | NEWARK
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State | NJ
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Zip | 07189-0001
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Country | US
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Telephone | 973-971-7184
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Fax | 973-290-8349
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SC01492100
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License Number State | NJ
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