Provider Demographics
NPI:1922474352
Name:LYNCH, ROBERT FRANK JR (CASAC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:FRANK
Last Name:LYNCH
Suffix:JR
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:287 SPRINGS FIREPLACE RD
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-4823
Mailing Address - Country:US
Mailing Address - Phone:631-329-0373
Mailing Address - Fax:631-907-9345
Practice Address - Street 1:287 SPRINGS FIREPLACE RD
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-4823
Practice Address - Country:US
Practice Address - Phone:631-329-0373
Practice Address - Fax:631-907-9345
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23996101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)