Provider Demographics
NPI:1265450787
Name:LYNCH, THOMAS FRANCIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:LYNCH
Suffix:
Gender:M
Credentials:LCSW
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 29
Mailing Address - Street 2:
Mailing Address - City:CROSSWICKS
Mailing Address - State:NJ
Mailing Address - Zip Code:08515-0029
Mailing Address - Country:US
Mailing Address - Phone:609-298-6463
Mailing Address - Fax:
Practice Address - Street 1:348 FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-1759
Practice Address - Country:US
Practice Address - Phone:609-324-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC043072001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ073524Medicare ID - Type UnspecifiedSOCIAL WORKER