Provider Demographics
NPI:1073091732
Name:LYNCH, ANDREA FAITH
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:FAITH
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CHERRY CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1340
Mailing Address - Country:US
Mailing Address - Phone:570-690-0969
Mailing Address - Fax:
Practice Address - Street 1:210 CHERRY CIR
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-1340
Practice Address - Country:US
Practice Address - Phone:570-690-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health