Provider Demographics
NPI:1124402185
Name:YOUNGER, LYNN DUNHAM (MSW, LSW,)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:DUNHAM
Last Name:YOUNGER
Suffix:
Gender:F
Credentials:MSW, LSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 LEXINGTON AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3727
Mailing Address - Country:US
Mailing Address - Phone:513-498-6396
Mailing Address - Fax:
Practice Address - Street 1:1954 LEXINGTON AVE APT 5
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-3727
Practice Address - Country:US
Practice Address - Phone:513-498-6396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-18
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2559501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH002161960OtherGRISWOLD CINCINNATI EAST