Provider Demographics
NPI:1366228546
Name:LYNCH, ERICA OLIVIA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:OLIVIA
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 CORPORATE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3132
Mailing Address - Country:US
Mailing Address - Phone:719-249-7896
Mailing Address - Fax:
Practice Address - Street 1:5040 CORPORATE PLAZA DR STE 7G
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-6100
Practice Address - Country:US
Practice Address - Phone:719-249-7896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker