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General NPI Number Information
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NPI Number | 1184865313
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Entity Type | Organization
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Legal Business Name | KIM LEHNERT, PSYCHOLOGY, PH.D., PLLC
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 5225 NESCONSET HWY
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-2053
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Country | US
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Telephone | 631-328-4262
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Fax | 631-504-0476
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Provider Business Mailing Address
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Address Line | 224 LIBERTY AVE
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-2010
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Country | US
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Telephone | 631-974-1443
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KIM LYNN LEHNERT
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Credential | PH.D.
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Telephone | 631-974-1443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 013596
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License Number State | NY
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