Provider Demographics
NPI:1134561210
Name:GRYCHOWSKI, LYNN DIANE (LSW)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:DIANE
Last Name:GRYCHOWSKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MISS
Other - First Name:LYNN
Other - Middle Name:DIANE
Other - Last Name:STANCLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:4301 LANCASTER ROAD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-5271
Mailing Address - Country:US
Mailing Address - Phone:814-836-6321
Mailing Address - Fax:814-836-6311
Practice Address - Street 1:4301 LANCASTER ROAD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-5271
Practice Address - Country:US
Practice Address - Phone:814-836-6321
Practice Address - Fax:814-836-6311
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW 010492L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical