Healthcare Provider Details

I. General information

NPI: 1891973079
Provider Name (Legal Business Name): PAULA FLYNN LPC, PSY.D.,NBCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2008
Last Update Date: 02/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WHIRLING DUN
COLLINSVILLE CT
06019-3219
US

IV. Provider business mailing address

55 RIVER RD
COLLINSVILLE CT
06019-3017
US

V. Phone/Fax

Practice location:
  • Phone: 860-693-6734
  • Fax: 860-693-1772
Mailing address:
  • Phone: 860-693-0602
  • Fax: 860-693-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000374
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: