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NPI Code Detail

MEDICARE: JEAN MARIE LYNCH

MEDICARE: JEAN MARIE LYNCH
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1629929138
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN MARIE LYNCH
Provider Business Mailing Address
First Line : 6479 MARDON DR
Second Line :
City : CONCORD TWP
State : OH
Zip : 44077-2005
Country : US
Telephone Number : 440-255-1700
Fax Number :
Provider Business Practice Location Address
First Line : 9220 MENTOR AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-6412
Country : US
Telephone Number : 440-255-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ JEAN MARIE LYNCH ” Practice Location

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