Provider Demographics
NPI:1972713485
Name:BYRNES, L. ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:L.
Middle Name:ANNE
Last Name:BYRNES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STADIUM RD, UNIVERSITY COUNSELING CENTER
Mailing Address - Street 2:STONY BROOK UNIVERSITY
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-3100
Mailing Address - Country:US
Mailing Address - Phone:631-632-6720
Mailing Address - Fax:631-632-9754
Practice Address - Street 1:STADIUM RD UNIVERSITY COUNSELING CTR
Practice Address - Street 2:STONY BROOK UNIVERSITY
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-3100
Practice Address - Country:US
Practice Address - Phone:631-632-6720
Practice Address - Fax:631-632-9754
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005260-1103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service