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NPI Code Detail

MEDICARE: MRS. JENNIFER LYNN LYNCH LPC

MEDICARE: MRS. JENNIFER LYNN LYNCH LPC
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
1261QM0855XAdolescent and Children Mental Health Clinic/Center5632-125WI
2101YM0800XMental Health Counselor5632-125WI
3101Y00000XCounselor5632-125WI
4101YP2500XProfessional Counselor5632-125WI

General Provider Information

NPI Number : 1386928422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER LYNN LYNCH LPC
Provider Business Mailing Address
First Line : 2545 N 29TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53210-3116
Country : US
Telephone Number : 414-562-2929
Fax Number :
Provider Business Practice Location Address
First Line : 2545 N 29TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53210-3116
Country : US
Telephone Number : 414-562-2929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2011
Last Update Date : 05/31/2023

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