Provider Demographics
NPI:1689635872
Name:LYNCH, JAMES J (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:LYNCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 BALTIMORE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4026
Mailing Address - Country:US
Mailing Address - Phone:410-321-5781
Mailing Address - Fax:410-296-0260
Practice Address - Street 1:606 BALTIMORE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4026
Practice Address - Country:US
Practice Address - Phone:410-321-5781
Practice Address - Fax:410-296-0260
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00869103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS874LIOtherBSMD
MD212374OtherKAISER
MD216155OtherMAMSI
MDA6600001OtherBC FEDERAL
MD216155OtherMAMSI