Provider Demographics
NPI:1003034158
Name:LYNCH, SAFI KHADIJA (LCSW-CLINICAL)
Entity Type:Individual
Prefix:MS
First Name:SAFI
Middle Name:KHADIJA
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LCSW-CLINICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20623-0244
Mailing Address - Country:US
Mailing Address - Phone:301-613-6808
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR
Practice Address - Street 2:SUITE 391
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4783
Practice Address - Country:US
Practice Address - Phone:301-583-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical