Provider Demographics
NPI:1194929653
Name:O'CONNELL, LYNN M (PSY D)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-1251
Mailing Address - Country:US
Mailing Address - Phone:585-376-2529
Mailing Address - Fax:833-736-8263
Practice Address - Street 1:118 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1251
Practice Address - Country:US
Practice Address - Phone:585-376-2529
Practice Address - Fax:833-736-8263
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015878103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist