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General NPI Number Information
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NPI Number | 1659627453
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Entity Type | Organization
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Legal Business Name | STONINGTON PSYCHOLOGY LLC
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 14 MASONS ISLAND RD UNIT 4
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City | MYSTIC
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State | CT
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Zip | 06355-2958
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Country | US
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Telephone | 860-245-9222
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Fax | 860-535-9891
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Provider Business Mailing Address
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Address Line | 14 MASONS ISLAND RD UNIT 4
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City | MYSTIC
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State | CT
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Zip | 06355-2958
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Country | US
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Telephone | 860-245-9222
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Fax | 860-535-9891
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINDA W SURIYAKHAM
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Credential | PHD
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Telephone | 860-245-9222
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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 | 003158
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License Number State | CT
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