Provider Demographics
NPI:1720252885
Name:OPSASNICK, LYNNE J (BS, MSW, LSW)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:J
Last Name:OPSASNICK
Suffix:
Gender:F
Credentials:BS, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-2325
Mailing Address - Country:US
Mailing Address - Phone:570-961-2421
Mailing Address - Fax:
Practice Address - Street 1:1615 E ELM ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-3925
Practice Address - Country:US
Practice Address - Phone:570-342-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1240111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASW124011OtherSOCIAL WORK LICENSE