Provider Demographics
NPI:1306149653
Name:LYNCH ERVIN, SAUNDRA ELAINA (EDD, LCPC, CEAP)
Entity type:Individual
Prefix:DR
First Name:SAUNDRA
Middle Name:ELAINA
Last Name:LYNCH ERVIN
Suffix:
Gender:F
Credentials:EDD, LCPC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 JOHNSBERG LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-7228
Mailing Address - Country:US
Mailing Address - Phone:301-613-5319
Mailing Address - Fax:301-249-8179
Practice Address - Street 1:313 JOHNSBERG LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-7228
Practice Address - Country:US
Practice Address - Phone:301-613-5319
Practice Address - Fax:301-249-8179
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC633101YP2500X
MD101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional