Provider Demographics
NPI:1447594213
Name:LYNCH, CAROL L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:L
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 FRANK COURT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NC
Mailing Address - Zip Code:07430
Mailing Address - Country:US
Mailing Address - Phone:201-891-2293
Mailing Address - Fax:
Practice Address - Street 1:14 EAST 48TH ST.
Practice Address - Street 2:FIRST CHURCH OF RELIGIOUS SCIENCE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-688-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100261600103TC0700X
NY009177-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical