Provider Demographics
NPI:1679207179
Name:YOCUM, LYNN (LSW)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:YOCUM
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-3086
Mailing Address - Country:US
Mailing Address - Phone:570-850-1151
Mailing Address - Fax:
Practice Address - Street 1:16 SHERWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-3086
Practice Address - Country:US
Practice Address - Phone:570-854-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138741104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker