Provider Demographics
NPI:1881606572
Name:CLYNICK, ANN (LLMSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:CLYNICK
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:467 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1539
Mailing Address - Country:US
Mailing Address - Phone:989-672-6160
Mailing Address - Fax:989-672-6272
Practice Address - Street 1:126 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5846
Practice Address - Country:US
Practice Address - Phone:989-684-7977
Practice Address - Fax:989-684-4331
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007396101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor