Provider Demographics
NPI:1053002402
Name:LYNCH, RICHARD L JR (LCADC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:LYNCH
Suffix:JR
Gender:M
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402A BROWNS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4609
Mailing Address - Country:US
Mailing Address - Phone:502-894-0234
Mailing Address - Fax:
Practice Address - Street 1:1402A BROWNS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4609
Practice Address - Country:US
Practice Address - Phone:502-894-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284565101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)