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General NPI Number Information
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NPI Number | 1588556088
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Entity Type | Organization
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Legal Business Name | LYNETTE KIRK, LLC
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 2207 E 12TH ST
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City | DAVENPORT
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State | IA
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Zip | 52803-3708
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Country | US
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Telephone | 563-484-0183
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 1ST ST
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City | COAL VALLEY
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State | IL
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Zip | 61240-9334
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Country | US
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Telephone | 563-484-0183
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LYNETTE KIRK
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Credential | LISW
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Telephone | 563-484-0183
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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 |
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License Number State |
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