Kristine Lynch, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149013645 Issued in IL

Practice address

12740 Elm St
Blue Island, IL 60406-1910

Phone

(773) 599-0802

NPI assigned

Apr 26, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Metropolitan Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1841460391
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1063703999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 ELM ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604061910",
            "telephone_number": "773-599-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 ELM ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604061910",
            "telephone_number": "773-599-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "KRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "26808",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifehouse Group, LLC (LifeHouse Group)
• Jeffrey Lin, MD
• Martin Francis Lowery, D.D.S.
• Lutheran Social Services of Illinois (LSSI Blue Island)
• Luv Home Care LLC
• Hoda Mahmoud, DMD
• Malinda Mommy's Helper LLC
• Kevin Paul Malone, D.P.M.
• Ramon Manglano, MD
• Avinash Mantha, MD

• Clinical Social Worker in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.