Provider Demographics
NPI:1356406094
Name:JONES, LYNNE B (LCSW)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W 71ST ST
Mailing Address - Street 2:SUITE# 6B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4139
Mailing Address - Country:US
Mailing Address - Phone:212-799-8553
Mailing Address - Fax:212-799-8553
Practice Address - Street 1:17 W 71ST ST
Practice Address - Street 2:SUITE# 6B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4139
Practice Address - Country:US
Practice Address - Phone:212-799-8553
Practice Address - Fax:212-799-8553
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR009509-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3441284OtherOXFORD
NY109239OtherVALUE OPTIONS
NYN14911Medicare ID - Type UnspecifiedLCSW