Healthcare Provider Details

I. General information

NPI: 1770414310
Provider Name (Legal Business Name): LYNN HOTALING NURSE PRACTITIONER IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 MAIN ST
CHATHAM NY
12037-1203
US

IV. Provider business mailing address

876 CARLSON RD
CRARYVILLE NY
12521-5142
US

V. Phone/Fax

Practice location:
  • Phone: 518-327-4751
  • Fax: 518-430-5115
Mailing address:
  • Phone: 518-327-4751
  • Fax: 518-430-5115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LYNN MARIE HOTALING
Title or Position: PMHNP
Credential: PMHNP-BC
Phone: 518-327-4751