Basic Information
| Provider Information | |||||||||
| NPI: | 1801090378 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OLSEFSKI | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 408 HARRELL ST | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278551818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2523704885 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1321 1ST ST W | ||||||||
| Address2: | |||||||||
| City: | AHOSKIE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279108842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522098932 | ||||||||
| FaxNumber: | 2522098933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2007 | ||||||||
| LastUpdateDate: | 02/17/2012 | ||||||||
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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 | 1041C0700X | 0904006583 | VA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | C006701 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.