Provider Demographics
NPI:1245517317
Name:SKUBISZEWSKI, LYNN K (LCSW)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:K
Last Name:SKUBISZEWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:K
Other - Last Name:ZACZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 LAKE ZURICH RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3141
Mailing Address - Country:US
Mailing Address - Phone:847-381-5599
Mailing Address - Fax:847-381-8042
Practice Address - Street 1:405 LAKE ZURICH RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3141
Practice Address - Country:US
Practice Address - Phone:847-381-5599
Practice Address - Fax:847-381-8042
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149008951104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12376494OtherCAQH