Lymes' Youth Service Bureau

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LYMES' YOUTH SERVICE BUREAU

Practice address

59 Lyme St
Old Lyme, CT 06371-2359

Phone

(860) 434-7208

Fax

(860) 434-1580

NPI assigned

Oct 26, 2012

Last updated

Oct 26, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mary Varisco Seidner

Title

Director

Phone

(860) 434-7208

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Elizabeth Groth, A.P.R.N., P.M.H.S.

  • Pediatric Nurse Practitioner
  • Old Lyme, CT
  • NPI 1508849076
  NPD (past)
• Kelly Dehart Lydiksen, LMFT-A

  • Marriage & Family Therapist
  • Old Saybrook, CT
  • NPI 1871446880

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1336492404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 LYME ST",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063712359",
            "telephone_number": "860-434-7208",
            "fax_number": "860-434-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 LYME ST",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063712359",
            "telephone_number": "860-434-7208",
            "fax_number": "860-434-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYMES' YOUTH SERVICE BUREAU",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "SEIDNER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "VARISCO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-434-7208",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Learn
• Amy C Lequire, BCBA
• Brenda L Lewis, OTR
• Julie Ann Liefeld, RN, PHD, LMFT
• Patricia Lirot, R.PH, B.S.
• Patricia G Lynch, R.D.
• Katie Rose Mattox, PHARMD
• Cindy McGrath, MSW
• Christina M McLean, M.D.
• Medop Behavioral Health Associates PC

• Clinical Social Worker in Old Lyme, CT
• Providers in Old Lyme, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.