Provider Demographics
NPI:1437345253
Name:BRINE, LYNN S (LICSW)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:S
Last Name:BRINE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ABIGAILS WAY
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2760
Mailing Address - Country:US
Mailing Address - Phone:508-428-2617
Mailing Address - Fax:
Practice Address - Street 1:5 ABIGAILS WAY
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2760
Practice Address - Country:US
Practice Address - Phone:508-428-2617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-16
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1108781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical