Individual
MRS. CAROLYN LYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
20 HOPE AVE, STE G05, WALTHAM, MA 02453-2721
(781) 893-8762
Mailing address
586 CENTRAL AVE, NEEDHAM HGTS, MA 02494-1463
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
111311
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042611055
TAX ID
—
01
—
1004745
NHP
—
01
—
1303287
MBHP
MA
05
—
1303287
—
MA
01
—
703136
TUFTS
—
01
—
99618201
NETWORK HEALTH
—
01
—
M18633
BCBS
MA
01
—
NP10332
BOSTON MED
—
01
—
P10329
BCBS
MA
Enumeration date
10/23/2006
Last updated
12/12/2012
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