Provider Demographics
NPI:1891985156
Name:KIM, LYNN S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:S
Last Name:KIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27303 SLEEPY HOLLOW
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545
Mailing Address - Country:US
Mailing Address - Phone:510-784-2079
Mailing Address - Fax:510-784-2767
Practice Address - Street 1:27303 SLEEPY HOLLOW
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545
Practice Address - Country:US
Practice Address - Phone:510-784-2079
Practice Address - Fax:510-784-2767
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA222581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical