Provider Demographics
NPI:1356564082
Name:TOD LYNCH-STANLEY COUNSELING SERVICES
Entity type:Organization
Organization Name:TOD LYNCH-STANLEY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH-STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-261-1248
Mailing Address - Street 1:1520 RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-6809
Mailing Address - Country:US
Mailing Address - Phone:912-261-1248
Mailing Address - Fax:912-261-1204
Practice Address - Street 1:1520 RICHMOND ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-6809
Practice Address - Country:US
Practice Address - Phone:912-261-1248
Practice Address - Fax:912-261-1204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBBZWMedicare ID - Type Unspecified