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NPI Code Detail

MEDICARE: MRS. LYN E. FLAHARDY LCSW

MEDICARE: MRS. LYN E. FLAHARDY LCSW
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
11041C0700XClinical Social Worker0904003812VA

General Provider Information

NPI Number : 1508836362
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYN E. FLAHARDY LCSW
Provider Business Mailing Address
First Line : 20791 MISTY WATERS PT
Second Line :
City : PITTSBURG
State : IL
Zip : 62974-1884
Country : US
Telephone Number : 618-982-2567
Fax Number :
Provider Business Practice Location Address
First Line : 109 LOU ANN DR
Second Line :
City : HERRIN
State : IL
Zip : 62948-3733
Country : US
Telephone Number : 618-988-1330
Fax Number : 618-988-8321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 02/12/2010

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