Provider Demographics
NPI:1326133547
Name:BIRNBAUM, LYNN F (PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:F
Last Name:BIRNBAUM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:F
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LYNN F MEYER
Mailing Address - Street 1:3180 N LAKE SHORE DR APT 8G
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4835
Mailing Address - Country:US
Mailing Address - Phone:917-841-1806
Mailing Address - Fax:
Practice Address - Street 1:3180 N LAKE SHORE DR APT 8G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4835
Practice Address - Country:US
Practice Address - Phone:917-841-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6881103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical