Provider Demographics
NPI:1285415133
Name:FLYNN, ZACHARY (LMSW)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:FLYNN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 144TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-1200
Mailing Address - Country:US
Mailing Address - Phone:860-301-9947
Mailing Address - Fax:
Practice Address - Street 1:100 PARK AVE FL 16
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5538
Practice Address - Country:US
Practice Address - Phone:212-433-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120732-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker