Provider Demographics
NPI:1679923882
Name:LAUREN FLYNN LLC
Entity type:Organization
Organization Name:LAUREN FLYNN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-827-5717
Mailing Address - Street 1:1001 PINE HEIGHTS AVENUE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229
Mailing Address - Country:US
Mailing Address - Phone:443-827-5717
Mailing Address - Fax:443-636-5385
Practice Address - Street 1:1001 PINE HEIGHTS AVENUE
Practice Address - Street 2:SUITE 302
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229
Practice Address - Country:US
Practice Address - Phone:443-827-5717
Practice Address - Fax:443-636-5385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-18
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD193761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119807600Medicaid