| Kristian Lynch, Lcsw, Llc | |
|
155 Kilburn Pl South Orange NJ 07079-2110 | |
| (917) 579-6396 | |
| Not Available |
| Full Name | Kristian Lynch, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 155 Kilburn Pl, South Orange, New Jersey |
| Authorized Official Name and Position | Kristian Lynch (OWNER) |
| Authorized Official Contact | 9175796396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristian Lynch, Lcsw, Llc 244 N Wyoming Ave South Orange NJ 07079-1600 Ph: (917) 579-6396 | Kristian Lynch, Lcsw, Llc 155 Kilburn Pl South Orange NJ 07079-2110 Ph: (917) 579-6396 |
| NPI Number | 1205650496 |
|---|---|
| Provider Enumeration Date | 11/13/2024 |
| Last Update Date | 11/13/2024 |
| Certification Date | 11/13/2024 |
| Medicare PECOS PAC ID | 8628503679 |
|---|---|
| Medicare Enrollment ID | O20241127001468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205650496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristian Earl Lynch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144626292 PECOS PAC ID: 6608189345 Enrollment ID: I20150723008341 |
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