Provider Demographics
NPI:1851306245
Name:SORBELLO, LYNN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:SORBELLO
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 MOTTER PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4557
Mailing Address - Country:US
Mailing Address - Phone:301-694-3613
Mailing Address - Fax:
Practice Address - Street 1:13 E 2ND ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5302
Practice Address - Country:US
Practice Address - Phone:301-694-8684
Practice Address - Fax:301-694-2984
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD081751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
758LJ224Medicare ID - Type UnspecifiedMEDICARE