MEDICARE: LYNNE E DULKEN 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
1	1041C0700X	Clinical Social Worker	C000901	NC

General Provider Information

NPI Number	:	1609096031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE E DULKEN LCSW

Provider Business Mailing Address
First Line	:	3610 SULKIRK ROAD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-6242
Country	:	US
Telephone Number	:	704-552-5252
Fax Number	:	704-552-9434

Provider Business Practice Location Address
First Line	:	3610 SULKIRK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-6242
Country	:	US
Telephone Number	:	704-552-5252
Fax Number	:	704-552-9434

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	09/07/2023

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