Provider Demographics
NPI:1770706178
Name:DAVIS, LYNNE C (LSW LMFT LMHC)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LSW LMFT LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 942
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:MA
Mailing Address - Zip Code:01379
Mailing Address - Country:US
Mailing Address - Phone:978-544-2067
Mailing Address - Fax:
Practice Address - Street 1:37 S PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:413-256-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA405101YM0800X
MA3105548104100000X
MA250106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist