Basic Information
| Provider Information | |||||||||
| NPI: | 1437401379 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GONZALEZ | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | D. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 STEPHANIE LN | ||||||||
| Address2: | |||||||||
| City: | CROTON ON HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105201551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143199636 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 481 MAIN ST | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | NEW ROCHELLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108016324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143552440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2012 | ||||||||
| LastUpdateDate: | 10/02/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | R034747-1 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.