Provider Demographics
NPI:1891822086
Name:BLASS, LYNN (MFT)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:BLASS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 DREW LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9495
Mailing Address - Country:US
Mailing Address - Phone:919-357-4701
Mailing Address - Fax:
Practice Address - Street 1:811 9TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4149
Practice Address - Country:US
Practice Address - Phone:919-357-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMFT1116106H00000X
CAMFC18872106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist