Provider Demographics
NPI:1508091067
Name:LYNCH, BETH ELLEN (MED, LCMHC)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ELLEN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MED, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 W MAIN ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:TILTON
Mailing Address - State:NH
Mailing Address - Zip Code:03276-5037
Mailing Address - Country:US
Mailing Address - Phone:603-630-2519
Mailing Address - Fax:
Practice Address - Street 1:29 PINE BROOK LN
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3029
Practice Address - Country:US
Practice Address - Phone:603-630-2519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NH975101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor