Provider Demographics
NPI:1780646380
Name:PASTOR, LYNNE (LCSW, LCADC,SAP,LLC)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:
Last Name:PASTOR
Suffix:
Gender:F
Credentials:LCSW, LCADC,SAP,LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1400
Mailing Address - Country:US
Mailing Address - Phone:973-584-3020
Mailing Address - Fax:973-598-9296
Practice Address - Street 1:54 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1400
Practice Address - Country:US
Practice Address - Phone:973-584-3020
Practice Address - Fax:973-598-9296
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050150001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical