Provider Demographics
NPI:1578942397
Name:JUMP, LYNSE MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:LYNSE
Middle Name:MARIE
Last Name:JUMP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LYNSE
Other - Middle Name:MARIE
Other - Last Name:BLOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1623 EDEN PARK DR APT 2
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-5527
Mailing Address - Country:US
Mailing Address - Phone:859-750-8089
Mailing Address - Fax:
Practice Address - Street 1:1623 EDEN PARK DR APT 2
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-5527
Practice Address - Country:US
Practice Address - Phone:859-750-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1300183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional