Provider Demographics
NPI:1386793727
Name:LYNN, CHRISTINE WAY (L I C S W)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:WAY
Last Name:LYNN
Suffix:
Gender:F
Credentials:L I C S W
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 39TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1964
Mailing Address - Country:US
Mailing Address - Phone:202-244-7073
Mailing Address - Fax:202-362-4852
Practice Address - Street 1:5324 39TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1964
Practice Address - Country:US
Practice Address - Phone:202-244-7073
Practice Address - Fax:202-362-4852
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC301 8631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
215 625OtherU HLT CARE
0951OtherB BS
215 625OtherU HLT CARE