Provider Demographics
NPI:1114065745
Name:LYNCH, CYNTHIA K (LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 ANNE BOLEYN CT SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5810
Mailing Address - Country:US
Mailing Address - Phone:770-739-2802
Mailing Address - Fax:770-745-5546
Practice Address - Street 1:2255 CUMBERLAND PKWY SE
Practice Address - Street 2:BUILDING 500, SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4515
Practice Address - Country:US
Practice Address - Phone:770-739-2802
Practice Address - Fax:770-745-5546
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002688101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional