Provider Demographics
NPI:1639349384
Name:KASS, LYNN (MA, MACP, LMHC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:KASS
Suffix:
Gender:F
Credentials:MA, MACP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 CAMBRIDGE TPKE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3726
Mailing Address - Country:US
Mailing Address - Phone:617-492-0050
Mailing Address - Fax:978-371-0879
Practice Address - Street 1:46 PEARL ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4041
Practice Address - Country:US
Practice Address - Phone:617-492-0050
Practice Address - Fax:978-371-0879
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health