Provider Demographics
NPI:1295014868
Name:ORTIZ, LYNNETTE ENID (LCSW/MPH)
Entity Type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:ENID
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LCSW/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE LEVY PLACE
Mailing Address - Street 2:BOX 1477 MOUNT SINAI HOSPITAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-987-7596
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE LEVY PLACE
Practice Address - Street 2:BOX 1477 MOUNT SINAI HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-987-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63496501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical