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General NPI Number Information
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NPI Number | 1770867483
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Entity Type | Individual
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Provider Name | JUDITH R LYNCH LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 165 MAIN ST STE A
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City | CORTLAND
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State | NY
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Zip | 13045
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Country | US
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Telephone | 607-753-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 16 KIMBERLY DR
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City | DRYDEN
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State | NY
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Zip | 13053-9728
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Country | US
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Telephone | 716-969-0404
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 085401
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License Number State | NY
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