Basic Information
Provider Information
NPI: 1487097853
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYNCH
FirstName: ASHLEY
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 515 BAYOU ST
Address2:  
City: VINCENNES
State: IN
PostalCode: 475911034
CountryCode: US
TelephoneNumber: 8128866800
FaxNumber: 8128866809
Practice Location
Address1: 121 BUNTIN ST
Address2:  
City: VINCENNES
State: IN
PostalCode: 47591
CountryCode: US
TelephoneNumber: 8128852700
FaxNumber: 8128852716
Other Information
ProviderEnumerationDate: 04/16/2013
LastUpdateDate: 05/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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