Provider Demographics
NPI:1811614514
Name:PAULELLA BEARD, LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:PAULELLA BEARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-1549
Mailing Address - Country:US
Mailing Address - Phone:860-567-4437
Mailing Address - Fax:860-567-0300
Practice Address - Street 1:25 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-4005
Practice Address - Country:US
Practice Address - Phone:860-567-4437
Practice Address - Fax:860-567-0300
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6708104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker