Provider Demographics
NPI:1174687511
Name:ROTHSTEIN, LYNNE (LMHC)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:ROTHSTEIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 MAIN ST
Mailing Address - Street 2:#37
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-4725
Mailing Address - Country:US
Mailing Address - Phone:978-640-3831
Mailing Address - Fax:978-640-3825
Practice Address - Street 1:1501 MAIN ST
Practice Address - Street 2:#37
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-4725
Practice Address - Country:US
Practice Address - Phone:978-640-3831
Practice Address - Fax:978-640-3825
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health