Provider Demographics
NPI:1154415164
Name:DICAPRIO, LYNNE S (MA)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:S
Last Name:DICAPRIO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:LYNNE
Other - Middle Name:S
Other - Last Name:DILULLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1204 HOLLY LANE
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342
Mailing Address - Country:US
Mailing Address - Phone:610-356-2100
Mailing Address - Fax:610-356-6645
Practice Address - Street 1:19 CAMPUS BLVD
Practice Address - Street 2:SUITE 102 DELAWARE COUNTY PROFESSIONAL SERVICES
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073
Practice Address - Country:US
Practice Address - Phone:610-356-2100
Practice Address - Fax:610-356-6645
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004778L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist