Provider Demographics
NPI:1659749596
Name:LYNCH, MARY MARGARET (CRC, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:MARGARET
Last Name:LYNCH
Suffix:
Gender:F
Credentials:CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2349 JAMESTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:IA
Mailing Address - Zip Code:50644-9709
Mailing Address - Country:US
Mailing Address - Phone:319-499-5366
Mailing Address - Fax:319-499-5366
Practice Address - Street 1:2349 JAMESTOWN AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:IA
Practice Address - Zip Code:50644-9709
Practice Address - Country:US
Practice Address - Phone:319-499-5366
Practice Address - Fax:319-499-5366
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00113598225C00000X
IA001344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor