Provider Demographics
NPI:1992821532
Name:YONACK, LYN (LICSW)
Entity type:Individual
Prefix:
First Name:LYN
Middle Name:
Last Name:YONACK
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 1:6 BRAINARD AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-528-5833
Mailing Address - Fax:
Practice Address - Street 1:291 MAIN ST
Practice Address - Street 2:#206
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1608
Practice Address - Country:US
Practice Address - Phone:413-528-5833
Practice Address - Fax:413-528-5833
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
280416000OtherMAGELLAN
P07805OtherBCBS