Provider Demographics
NPI:1811067267
Name:NAFZIGER-LYNE, SHIRLEY (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:NAFZIGER-LYNE
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:NAFZIGER-LYNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-691-8070
Mailing Address - Fax:277-069-1802
Practice Address - Street 1:811 E PARRISH AVE STE 102
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3258
Practice Address - Country:US
Practice Address - Phone:270-688-2077
Practice Address - Fax:270-688-2078
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40181041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101835320 0001Medicaid
PA101835320 0001Medicaid
KYK181760Medicare PIN
KY7100408400Medicaid
IN249390024Medicare PIN