MEDICARE: JENNIFER LYNCH MA, LMFT

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	101Y00000X	Counselor	80620	CA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	80620	CA
3	101YM0800X	Mental Health Counselor	80620	CA
4	102L00000X	Psychoanalyst	80620	CA
5	106H00000X	Marriage & Family Therapist	80620	CA

General Provider Information

NPI Number	:	1487078317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNCH MA, LMFT

Provider Business Mailing Address
First Line	:	1110 N VIRGIL AVE # 252
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-2016
Country	:	US
Telephone Number	:	805-795-3344
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 N VIRGIL AVE # 252
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-2016
Country	:	US
Telephone Number	:	805-795-3344
Fax Number	:

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

Provider Enumeration Date	:	02/12/2014
Last Update Date	:	07/27/2023

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