Provider Demographics
NPI:1821147828
Name:LYNCH GAFFNEY, KATHLEEN M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:LYNCH GAFFNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:329 UNION ST
Mailing Address - Street 2:#4E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231
Mailing Address - Country:US
Mailing Address - Phone:718-945-7150
Mailing Address - Fax:718-634-4838
Practice Address - Street 1:6200 BEACH CHANNEL DR
Practice Address - Street 2:JOSEPH P ADDABBO FAMILY HEALTH
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692
Practice Address - Country:US
Practice Address - Phone:718-945-7150
Practice Address - Fax:718-634-4838
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYR0361731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
14514540UMedicare UPIN