Provider Demographics
NPI:1982166500
Name:LYNCH, BRIGID GRACE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:GRACE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31209 SLEEPY HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-3621
Mailing Address - Country:US
Mailing Address - Phone:248-330-2474
Mailing Address - Fax:
Practice Address - Street 1:30300 TELEGRAPH RD STE 125
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4505
Practice Address - Country:US
Practice Address - Phone:248-330-2474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health