Provider Demographics
NPI:1063150258
Name:LYNCH, CHRISTINE (MA,LCMHC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MA,LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CLIFFORD DR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468-4627
Mailing Address - Country:US
Mailing Address - Phone:860-593-9224
Mailing Address - Fax:
Practice Address - Street 1:186 LAKE ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2238
Practice Address - Country:US
Practice Address - Phone:802-559-0418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0134558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health