Provider Demographics
NPI:1346329737
Name:BIERNACKI, LYNNE (LMSW, LMFT)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:BIERNACKI
Suffix:
Gender:F
Credentials:LMSW, LMFT
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:GORMAN
Other - Last Name:SALISBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW, LMFT
Mailing Address - Street 1:3663 LAKESHORE DR N
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1114
Mailing Address - Country:US
Mailing Address - Phone:616-399-4949
Mailing Address - Fax:616-399-4949
Practice Address - Street 1:3663 LAKESHORE DR N
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-1114
Practice Address - Country:US
Practice Address - Phone:616-399-4949
Practice Address - Fax:616-399-4949
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101005176104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker