Provider Demographics
NPI:1265652960
Name:LYNCH, RUTHIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:RUTHIE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ELM ST
Mailing Address - Street 2:
Mailing Address - City:VERNON ROCKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3240
Mailing Address - Country:US
Mailing Address - Phone:860-875-0292
Mailing Address - Fax:860-871-4910
Practice Address - Street 1:60 ELM ST
Practice Address - Street 2:
Practice Address - City:VERNON ROCKVILLE
Practice Address - State:CT
Practice Address - Zip Code:06066-3240
Practice Address - Country:US
Practice Address - Phone:860-875-0292
Practice Address - Fax:860-871-4910
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001556101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional