Basic Information
| Provider Information | |||||||||
| NPI: | 1003032582 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LYNCH | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN, LADC 1 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 833 FEDERAL ST | ||||||||
| Address2: | |||||||||
| City: | BELCHERTOWN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010079373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132591085 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2257 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011071905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137333488 | ||||||||
| FaxNumber: | 4137317381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 906 | MA | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 163W00000X | 110571 | MA | X | Nursing Service Providers | Registered Nurse |
No ID Information.