Healthcare Provider Details

I. General information

NPI: 1730251935
Provider Name (Legal Business Name): LYN E STYCZYNSKI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 MT AUBURN ST
WATERTOWN MA
02472-4005
US

IV. Provider business mailing address

106 WILDWOOD AVE
ARLINGTON MA
02476-6224
US

V. Phone/Fax

Practice location:
  • Phone: 781-641-2210
  • Fax: 781-648-4777
Mailing address:
  • Phone: 781-641-2210
  • Fax: 781-648-4717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2320
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2320
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number2320
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: