Provider Demographics
NPI:1669910386
Name:LYNCH, VALEENE
Entity type:Individual
Prefix:
First Name:VALEENE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ENCINO PL NE STE E1
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2645
Mailing Address - Country:US
Mailing Address - Phone:505-272-2573
Mailing Address - Fax:505-272-7751
Practice Address - Street 1:801 ENCINO PL NE STE E1
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2645
Practice Address - Country:US
Practice Address - Phone:505-272-2573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSW-2024-1096104100000X
NM171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator