Provider Demographics
NPI:1568982593
Name:LYNCH, ALYSSA LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LOUISE
Last Name:LYNCH
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 1:4100 VOLTAIRE ST UNIT 210
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-1876
Mailing Address - Country:US
Mailing Address - Phone:703-517-9072
Mailing Address - Fax:
Practice Address - Street 1:4100 VOLTAIRE ST UNIT 210
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-1876
Practice Address - Country:US
Practice Address - Phone:703-517-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000012461041C0700X
CALCSW943301041C0700X
PACW0220681041C0700X
VA09040099611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical