Provider Demographics
NPI:1265128862
Name:LYNCH, STEPHANIE (MS, CRC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MS, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHARPE ST
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:PA
Mailing Address - Zip Code:18644-2118
Mailing Address - Country:US
Mailing Address - Phone:570-313-5618
Mailing Address - Fax:
Practice Address - Street 1:480 PIERCE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5512
Practice Address - Country:US
Practice Address - Phone:570-313-5618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor