Provider Demographics
NPI:1588089270
Name:LYNCH, ERIN (MSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 GRAYGATE CT
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-4359
Mailing Address - Country:US
Mailing Address - Phone:636-561-9156
Mailing Address - Fax:
Practice Address - Street 1:206 GRAYGATE CT
Practice Address - Street 2:
Practice Address - City:LAKE SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-4359
Practice Address - Country:US
Practice Address - Phone:317-989-6105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080160471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical