Provider Demographics
NPI:1720469216
Name:LYNCH, COURTNEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 CANOE BROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1404
Mailing Address - Country:US
Mailing Address - Phone:732-648-8153
Mailing Address - Fax:
Practice Address - Street 1:123 CANOE BROOK PKWY
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1404
Practice Address - Country:US
Practice Address - Phone:732-648-8153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ01696197103T00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst