MEDICARE: MS. KAYLEIGH LYNCH I LMSW

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
1	104100000X	Social Worker
2	104100000X	Social Worker	5971	CT

General Provider Information

NPI Number	:	1336695113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAYLEIGH LYNCH I LMSW

Provider Business Mailing Address
First Line	:	3377 S PRICE RD STE 110
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-3573
Country	:	US
Telephone Number	:	480-280-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	3377 S PRICE RD
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-3573
Country	:	US
Telephone Number	:	480-280-8888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	03/14/2023

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