1003034158 NPI number — MS. SAFI KHADIJA LYNCH L.C.S.W.-CLINICAL

Table of content: MS. SAFI KHADIJA LYNCH L.C.S.W.-CLINICAL (NPI 1003034158)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003034158 NPI number — MS. SAFI KHADIJA LYNCH L.C.S.W.-CLINICAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
SAFI
Provider Middle Name:
KHADIJA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.-CLINICAL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003034158
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 244
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHELTENHAM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20623-0244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-613-6808
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9701 APOLLO DR
Provider Second Line Business Practice Location Address:
SUITE 391
Provider Business Practice Location Address City Name:
UPPER MARLBORO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20774-4783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-583-1181
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  15843 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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