Provider Demographics
NPI:1720522113
Name:KELLNER, LYNNE MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:MARIE
Last Name:KELLNER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 GREEN LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1533
Mailing Address - Country:US
Mailing Address - Phone:914-666-0511
Mailing Address - Fax:
Practice Address - Street 1:132 GREEN LN
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1533
Practice Address - Country:US
Practice Address - Phone:914-666-0511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14008-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical