Provider Demographics
NPI:1558693101
Name:LYNCH, HOLLY MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:MARIE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:HOLLY
Other - Middle Name:MARIE
Other - Last Name:LYNCH WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:118 E. SUNBRIDGE DR.
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-444-1400
Mailing Address - Fax:479-444-1422
Practice Address - Street 1:118 E. SUNBRIDGE DR.
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-444-1400
Practice Address - Fax:479-444-1422
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ARA1004054101YM0800X
ARP13040444101YM0800X
ARP1304044101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator