Provider Demographics
NPI:1952627762
Name:FLYNN, VIRGINIA (MS, LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MS, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-2387
Mailing Address - Country:US
Mailing Address - Phone:315-422-0300
Mailing Address - Fax:
Practice Address - Street 1:3300 JAMES ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-2387
Practice Address - Country:US
Practice Address - Phone:315-422-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical