Provider Demographics
NPI:1679633200
Name:ROSENZWEIG HENSLEY, LYNN A (PSYD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:ROSENZWEIG HENSLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CRANES ROOST CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3650
Mailing Address - Country:US
Mailing Address - Phone:270-765-2605
Mailing Address - Fax:270-234-8572
Practice Address - Street 1:107 CRANES ROOST CT
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-3650
Practice Address - Country:US
Practice Address - Phone:270-765-2605
Practice Address - Fax:270-234-8572
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 1409103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000500824OtherANTHEM
KY30605018Medicaid
KY0359299Medicare ID - Type UnspecifiedGRP 3592
KY0763542Medicare ID - Type UnspecifiedGRP 7635
KY0974715Medicare PIN
KY00199002Medicare ID - Type UnspecifiedGRP 3589
KY000000500824OtherANTHEM
KY00200002Medicare ID - Type UnspecifiedGRP3590
KY00201001Medicare ID - Type UnspecifiedGRP 3588
KY30605018Medicaid
KY0359299Medicare PIN
KY0358699Medicare ID - Type UnspecifiedGRP 3586
KY0358799Medicare ID - Type UnspecifiedGRP 3587
KY0974715Medicare ID - Type UnspecifiedGRP 9747
KY0762342Medicare ID - Type UnspecifiedGRP 7623