Healthcare Provider Details

I. General information

NPI: 1528340551
Provider Name (Legal Business Name): LYNNE FLANAGAN TSOMBAKOS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 GOLD STAR BLVD
WORCESTER MA
01606-2738
US

IV. Provider business mailing address

135 GOLD STAR BLVD
WORCESTER MA
01606-2738
US

V. Phone/Fax

Practice location:
  • Phone: 855-496-8462
  • Fax: 508-849-5618
Mailing address:
  • Phone: 508-849-5600
  • Fax: 508-849-5618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12388
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: