Provider Demographics
NPI:1801997770
Name:LYNNE, BARBARA (MSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LYNNE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SCHOOL ST
Mailing Address - Street 2:#310
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:438 KING ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1269
Practice Address - Country:US
Practice Address - Phone:978-952-6060
Practice Address - Fax:978-486-8104
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10254651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO8023Medicare UPIN
MAPO8023Medicare ID - Type Unspecified
MA009339Medicare UPIN
MA461381Medicare UPIN