Provider Demographics
NPI:1477839314
Name:BIRNHOLZ, LYNNE RUTH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:RUTH
Last Name:BIRNHOLZ
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 1:39 GATEHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2706
Mailing Address - Country:US
Mailing Address - Phone:716-407-9275
Mailing Address - Fax:716-407-9007
Practice Address - Street 1:9625 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-2001
Practice Address - Country:US
Practice Address - Phone:716-407-9275
Practice Address - Fax:716-407-9007
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070225-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool