Provider Demographics
NPI:1174747364
Name:STORM-LYNCH, DONNA (MSW,LCSW)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:STORM-LYNCH
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SUNNYSIDE BLVD.
Mailing Address - Street 2:SUITE F
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1517
Mailing Address - Country:US
Mailing Address - Phone:516-349-0355
Mailing Address - Fax:516-349-8680
Practice Address - Street 1:54 SUNNYSIDE BLVD.
Practice Address - Street 2:SUITE F
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1517
Practice Address - Country:US
Practice Address - Phone:516-349-0355
Practice Address - Fax:516-349-8680
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039219-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4381596OtherAETNA
NYN76811OtherEMPIRE
NY055528OtherVALUE OPTIONS
NY3696OtherBEACON HEALTH
NY7403030OtherGHI