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NPI Code Detail

MEDICARE: LISA M LYNCH, LICSW LLC

MEDICARE: LISA M LYNCH, LICSW LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302F00000XExclusive Provider Organization114584MA

General Provider Information

NPI Number : 1295268092
Entity Type Code : Organization
Provider Name (Legal Business Name) : LISA M LYNCH, LICSW LLC
Provider Business Mailing Address
First Line : 44 HILL ST
Second Line :
City : TEWKSBURY
State : MA
Zip : 01876-3025
Country : US
Telephone Number : 978-364-0214
Fax Number :
Provider Business Practice Location Address
First Line : 80 MAPLE ST
Second Line : SUITE 101
City : STONEHAM
State : MA
Zip : 02180-3143
Country : US
Telephone Number : 978-364-0214
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : LISA M LYNCH
Credential : LICSW
Telephone Number : 978-364-0214
Provider Enumeration Date : 04/07/2017
Last Update Date : 04/07/2017

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Directions to “LISA M LYNCH, LICSW LLC ” Practice Location

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