Provider Demographics
NPI:1801308713
Name:LYNCH, LINDA JOYCE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JOYCE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:GROVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:2029 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3405
Mailing Address - Country:US
Mailing Address - Phone:816-221-0305
Mailing Address - Fax:816-221-9121
Practice Address - Street 1:2029 BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3405
Practice Address - Country:US
Practice Address - Phone:816-221-0305
Practice Address - Fax:816-221-0305
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
KS19771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical