Provider Demographics
NPI:1659627453
Name:STONINGTON PSYCHOLOGY LLC
Entity type:Organization
Organization Name:STONINGTON PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:W
Authorized Official - Last Name:SURIYAKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-245-9222
Mailing Address - Street 1:14 MASONS ISLAND RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2958
Mailing Address - Country:US
Mailing Address - Phone:860-245-9222
Mailing Address - Fax:860-535-9891
Practice Address - Street 1:14 MASONS ISLAND RD UNIT 4
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2958
Practice Address - Country:US
Practice Address - Phone:860-245-9222
Practice Address - Fax:860-535-9891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003158103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty