Provider Demographics
NPI:1295975092
Name:FLYNN, MATTHEW J (PSYD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:FLYNN
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 1:117 PHILLIPS CMN
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4047
Mailing Address - Country:US
Mailing Address - Phone:978-482-7991
Mailing Address - Fax:
Practice Address - Street 1:955 MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-4300
Practice Address - Country:US
Practice Address - Phone:978-482-1991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31378OtherDATE OF BIRTH