Provider Demographics
NPI:1437949534
Name:LYNCH, JOHANNA (LSW)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LYONSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-9555
Mailing Address - Country:US
Mailing Address - Phone:862-812-8792
Mailing Address - Fax:
Practice Address - Street 1:30 LYONSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-9555
Practice Address - Country:US
Practice Address - Phone:862-812-8792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07064000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker