Provider Demographics
NPI:1891973079
Name:FLYNN, PAULA (LPC, PSYD,NBCC)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LPC, PSYD,NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06019-3017
Mailing Address - Country:US
Mailing Address - Phone:860-693-0602
Mailing Address - Fax:860-693-1772
Practice Address - Street 1:10 WHIRLING DUN
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3219
Practice Address - Country:US
Practice Address - Phone:860-693-6734
Practice Address - Fax:860-693-1772
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000374101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT240000374CT02OtherANTHEM
CT240000374CT04OtherANTHEM