Healthcare Provider Details

I. General information

NPI: 1811614514
Provider Name (Legal Business Name): LYNN PAULELLA BEARD LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 S MAIN ST
CHESHIRE CT
06410-3171
US

IV. Provider business mailing address

195 S MAIN ST # 205
CHESHIRE CT
06410-3171
US

V. Phone/Fax

Practice location:
  • Phone: 203-587-3742
  • Fax:
Mailing address:
  • Phone: 203-587-3742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6708
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15528
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: