Provider Demographics
NPI:1558477539
Name:OXBOEL, LYNNE P (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:P
Last Name:OXBOEL
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 1:59 MARION AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1905
Mailing Address - Country:US
Mailing Address - Phone:914-864-1412
Mailing Address - Fax:
Practice Address - Street 1:59 MARION AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1905
Practice Address - Country:US
Practice Address - Phone:914-864-1412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0489241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNF3461Medicare ID - Type UnspecifiedLCSW