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General NPI Number Information
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NPI Number | 1528432580
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Entity Type | Organization
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Legal Business Name | MARTIN D LYNCH
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 70 NORTH ST STE 201
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City | DANBURY
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State | CT
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Zip | 06810-5609
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Country | US
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Telephone | 203-313-7356
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Fax |
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Provider Business Mailing Address
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Address Line | 70 NORTH ST STE 201
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City | DANBURY
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State | CT
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Zip | 06810-5609
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Country | US
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Telephone | 203-313-7356
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MR. MARTIN D LYNCH
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Credential | MS LPC
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Telephone | 203-313-7356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 669
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License Number State | CT
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