Provider Demographics
NPI:1043884695
Name:LYNN, LAUREN ASHLEY (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEY
Last Name:LYNN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ASHLEY
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QMHP-C
Mailing Address - Street 1:335 GREENBRIER DR STE 206
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1695
Mailing Address - Country:US
Mailing Address - Phone:434-220-0333
Mailing Address - Fax:434-220-1647
Practice Address - Street 1:335 GREENBRIER DR STE 206
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1695
Practice Address - Country:US
Practice Address - Phone:434-220-0333
Practice Address - Fax:434-220-1647
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040124391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical