Provider Demographics
NPI:1639227259
Name:LYNN, GEORGE L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:L
Last Name:LYNN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475
Mailing Address - Country:US
Mailing Address - Phone:860-388-1626
Mailing Address - Fax:860-395-1380
Practice Address - Street 1:929 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475
Practice Address - Country:US
Practice Address - Phone:860-388-1626
Practice Address - Fax:860-395-1380
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001520103T00000X
NY007622103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist