Provider Demographics
NPI:1164448312
Name:ODINOV-DANIELS, LYNN (LCSW; NCPSYA)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:
Last Name:ODINOV-DANIELS
Suffix:
Gender:F
Credentials:LCSW; NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10492 GALLERIA ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3160
Mailing Address - Country:US
Mailing Address - Phone:561-422-1145
Mailing Address - Fax:561-422-3198
Practice Address - Street 1:10492 GALLERIA ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3160
Practice Address - Country:US
Practice Address - Phone:561-422-1145
Practice Address - Fax:561-422-3198
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLCSW:6942101YM0800X
NYLCSW:R044008101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP911096OtherNCPSYA
FLSW6942OtherLCSW
NYR044008OtherLCSW
FL11348023OtherCAQH
FL11348023OtherCAQH
NYP911096OtherNCPSYA