Provider Demographics
NPI:1003820929
Name:LIRETTE, LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:LIRETTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:HALWAX-LIRETTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5740 N PALM
Mailing Address - Street 2:#105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1800
Mailing Address - Country:US
Mailing Address - Phone:559-224-8419
Mailing Address - Fax:559-431-1951
Practice Address - Street 1:5740 N PALM
Practice Address - Street 2:#105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1800
Practice Address - Country:US
Practice Address - Phone:559-224-8419
Practice Address - Fax:559-431-1951
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS54461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical