Provider Demographics
NPI:1275225823
Name:LYNCH, KATHERINE MAUREEN (LGPC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAUREEN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4559
Mailing Address - Country:US
Mailing Address - Phone:667-600-2115
Mailing Address - Fax:
Practice Address - Street 1:308 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4559
Practice Address - Country:US
Practice Address - Phone:667-600-2115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11837101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional