Provider Demographics
NPI:1043790975
Name:LYNCH, JANICE L (LMSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3437 E HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2220
Mailing Address - Country:US
Mailing Address - Phone:480-558-6604
Mailing Address - Fax:480-827-2468
Practice Address - Street 1:325 E ELLIOT RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1126
Practice Address - Country:US
Practice Address - Phone:480-827-2440
Practice Address - Fax:480-827-2468
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW12855104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker