Active NPI
Olivia Shipp Lynch
- Psychologist
- Clinton, NC
National Provider Identifier
1093334708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6192
- Practice address
- 738 Cedar Lake LN
Clinton, NC 28328-8792 - Phone
- (910) 236-6848
- NPI assigned
- Apr 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6192 | NC | Primary |
Addresses
Primary practice location
738 Cedar Lake LN
Clinton, NC 28328-8792
Mailing address
5540 Centerview Dr Ste 204
PMB 285102
Raleigh, NC 27606-8012
Phone (910) 236-6848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6192 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1093334708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5540 CENTERVIEW DR STE 204",
"address_2": "PMB 285102",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276068012",
"telephone_number": "910-236-6848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "738 CEDAR LAKE LN",
"city": "CLINTON",
"state": "NC",
"postal_code": "283288792",
"telephone_number": "910-236-6848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "OLIVIA",
"middle_name": "SHIPP",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-13",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "6192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.