Provider Demographics
NPI:1891451530
Name:MICHELLE S LYNCH PSYD PLLC
Entity Type:Organization
Organization Name:MICHELLE S LYNCH PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:248-808-7681
Mailing Address - Street 1:2482 ANN SQ
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-4521
Mailing Address - Country:US
Mailing Address - Phone:248-808-7681
Mailing Address - Fax:
Practice Address - Street 1:2482 ANN SQ
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-4521
Practice Address - Country:US
Practice Address - Phone:248-808-7681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty