Provider Demographics
NPI:1083899793
Name:LYNCH, HILARY ANN (LICSW, MSW)
Entity Type:Individual
Prefix:MS
First Name:HILARY
Middle Name:ANN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LICSW, MSW
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 174
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-0174
Mailing Address - Country:US
Mailing Address - Phone:802-299-6826
Mailing Address - Fax:
Practice Address - Street 1:306 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-4418
Practice Address - Country:US
Practice Address - Phone:802-299-6826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
VT089.00650361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health