Provider Demographics
NPI:1952450389
Name:PERONE, LYNN ANN (MSW)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:PERONE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 TRUMBULL ST # 39
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-1005
Mailing Address - Country:US
Mailing Address - Phone:203-776-9795
Mailing Address - Fax:
Practice Address - Street 1:37 TRUMBULL ST # 39
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1005
Practice Address - Country:US
Practice Address - Phone:203-776-9795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0011771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical