Provider Demographics
NPI:1477299345
Name:LYNN GOLDSTEIN, LCSW
Entity Type:Organization
Organization Name:LYNN GOLDSTEIN, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-551-0320
Mailing Address - Street 1:46 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6619
Mailing Address - Country:US
Mailing Address - Phone:516-551-0320
Mailing Address - Fax:
Practice Address - Street 1:2470 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:N BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1827
Practice Address - Country:US
Practice Address - Phone:516-551-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty