1265585210 NPI number — MRS. LYNN DORFMAN-VOLIN M.S.W.,L.M.F.T.

Table of content: MRS. LYNN DORFMAN-VOLIN M.S.W.,L.M.F.T. (NPI 1265585210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265585210 NPI number — MRS. LYNN DORFMAN-VOLIN M.S.W.,L.M.F.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DORFMAN-VOLIN
Provider First Name:
LYNN
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W.,L.M.F.T.
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:
1265585210
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E LINTON BLVD
Provider Second Line Business Mailing Address:
SUITE 154A
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33483-3327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-243-1050
Provider Business Mailing Address Fax Number:
561-243-1050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E LINTON BLVD
Provider Second Line Business Practice Location Address:
SUITE 154A
Provider Business Practice Location Address City Name:
DELRAY BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33483-3327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-243-1050
Provider Business Practice Location Address Fax Number:
561-243-1050
Provider Enumeration Date:
01/20/2007

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:  MT0001069 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: MT0001069 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 012469 . This is a "HUMANA PSYCHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 119784 . This is a "VALUE OPTIONS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 62-19113 . This is a "UBH UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 17167199 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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