Provider Demographics
NPI:1548315542
Name:TEMPLE, LYNDA D (LCSW CASAC)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:D
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:LCSW CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 W JOHN ST
Mailing Address - Street 2:HICKSVILLE
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1033
Mailing Address - Country:US
Mailing Address - Phone:516-935-6858
Mailing Address - Fax:516-935-2717
Practice Address - Street 1:385 W JOHN ST
Practice Address - Street 2:HICKSVILLE
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1033
Practice Address - Country:US
Practice Address - Phone:516-935-6858
Practice Address - Fax:516-935-2717
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0595321041C0700X
NY11394101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)