Provider Demographics
NPI:1275688103
Name:GENSER, LYNE TAYLOR (MSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:LYNE
Middle Name:TAYLOR
Last Name:GENSER
Suffix:
Gender:M
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8905 WANDERING TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2379
Mailing Address - Country:US
Mailing Address - Phone:703-550-4806
Mailing Address - Fax:703-931-1931
Practice Address - Street 1:5614 SHIELDS DR
Practice Address - Street 2:WYNGATE MEDICAL PARK
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-3532
Practice Address - Country:US
Practice Address - Phone:703-550-4806
Practice Address - Fax:703-931-1931
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD39031041C0700X
VA5501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical