Provider Demographics
NPI:1134371149
Name:KYNVI, LI LYNN (MDIV,MA, MT-BC, LMHC)
Entity type:Individual
Prefix:
First Name:LI
Middle Name:LYNN
Last Name:KYNVI
Suffix:
Gender:F
Credentials:MDIV,MA, MT-BC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 TOWNSEND RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1604
Mailing Address - Country:US
Mailing Address - Phone:508-395-8712
Mailing Address - Fax:
Practice Address - Street 1:274 MAIN ST UNIT C
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1236
Practice Address - Country:US
Practice Address - Phone:978-488-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC6740101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty