Provider Demographics
NPI:1467250142
Name:LYNCH, JENNIFER S (LCSW-R)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:LYNCH
Suffix:
Gender:
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WALBROOKE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2634
Mailing Address - Country:US
Mailing Address - Phone:917-597-3350
Mailing Address - Fax:
Practice Address - Street 1:41 WALBROOKE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2634
Practice Address - Country:US
Practice Address - Phone:917-597-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-030309-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical