Provider Demographics
NPI:1376698811
Name:LYNCH, RHONDA KAYE (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAYE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:FL
Mailing Address - Zip Code:32693-3239
Mailing Address - Country:US
Mailing Address - Phone:352-463-4504
Mailing Address - Fax:
Practice Address - Street 1:1830 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:FL
Practice Address - Zip Code:32619-4713
Practice Address - Country:US
Practice Address - Phone:352-463-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLSW11112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1245532209OtherNPI 2-GROUP
FL007186400Medicaid