Provider Demographics
NPI:1952434136
Name:BARNARD, LYNN DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:DENISE
Last Name:BARNARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 W 190TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-4223
Mailing Address - Country:US
Mailing Address - Phone:233-328-2960
Mailing Address - Fax:
Practice Address - Street 1:879 W 190TH ST STE 400
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4223
Practice Address - Country:US
Practice Address - Phone:323-328-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA213121041C0700X
CALCS213121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGA275ZOtherMEDICARE PTAN
CAGA275ZOtherMENTAL HEALTH
CAGA275ZMedicaid