Dacosta, Lynne Michelle
Dacosta, Lynne Michelle is an individual health care provider with primary practice located at 1627 S Hargrave St , Banning CA 92220-6169. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dacosta, Lynne Michelle can be contacted via phone (951) 922-7840.Contact Information
Primary practice address
1627 S Hargrave St
Banning CA 92220-6169
Phone: (951) 922-7840
Fax: (951) 922-7752
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 21205 | California |
Profile Details
NPI number | 1629150628 |
---|---|
LBN Legal business name | Dacosta, Lynne Michelle |
Credentials | Licensed Clinical Social Worker (LCSW) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 19th, 2006 |
Last updated | Apr 14th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629150628 | NPPES |
California | Other | LCS 21205 | L.C.S.W. |
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