Provider Demographics
NPI:1770019168
Name:RYNN, STEPHEN WILLIAM (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WILLIAM
Last Name:RYNN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PRINCESS RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2322
Mailing Address - Country:US
Mailing Address - Phone:609-482-3701
Mailing Address - Fax:609-482-3702
Practice Address - Street 1:4 PRINCESS RD
Practice Address - Street 2:SUITE 206
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2322
Practice Address - Country:US
Practice Address - Phone:609-482-3701
Practice Address - Fax:609-482-3702
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO57106001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical