Provider Demographics
NPI:1588707665
Name:WERTHAMER, LYNN HALE (LICSW)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:HALE
Last Name:WERTHAMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 TRUMBULL RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3036
Mailing Address - Country:US
Mailing Address - Phone:413-586-4284
Mailing Address - Fax:413-586-4284
Practice Address - Street 1:31 TRUMBULL RD
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3036
Practice Address - Country:US
Practice Address - Phone:413-586-4284
Practice Address - Fax:413-586-4284
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10166041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP04894OtherBLUE CROSS BLUE SHIELD