Provider Demographics
NPI:1982129862
Name:FLYNN, JOANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SWANSWOOD LN
Mailing Address - Street 2:
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-1867
Mailing Address - Country:US
Mailing Address - Phone:860-460-7051
Mailing Address - Fax:
Practice Address - Street 1:49 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5001
Practice Address - Country:US
Practice Address - Phone:860-889-2413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003233101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional