Provider Demographics
NPI:1790145050
Name:KUZNETSKY, LYNNE FAITH (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:FAITH
Last Name:KUZNETSKY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16916 ADLON RD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-3813
Mailing Address - Country:US
Mailing Address - Phone:818-231-9598
Mailing Address - Fax:
Practice Address - Street 1:16260 VENTURA BLVD STE LL30
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4927
Practice Address - Country:US
Practice Address - Phone:818-231-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT17420106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist