Active NPI
George L Lynn, PSYD
- Psychologist
- Old Saybrook, CT
National Provider Identifier
1639227259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 001520
- Practice address
- 929 Boston Post Rd
Old Saybrook, CT 06475 - Phone
- (860) 388-1626
- Fax
- (860) 395-1380
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 001520 | CT | Primary |
| Psychologist | 103T00000X | 007622 | NY |
Addresses
Primary practice location
929 Boston Post Rd
Old Saybrook, CT 06475
Mailing address
929 Boston Post Rd
Old Saybrook, CT 06475
Phone (860) 388-1626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 18, 2023 through Apr 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001520 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639227259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 BOSTON POST RD",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "06475",
"telephone_number": "860-388-1626",
"fax_number": "860-395-1380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 BOSTON POST RD",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "06475",
"telephone_number": "860-388-1626",
"fax_number": "860-395-1380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNN",
"first_name": "GEORGE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "001520",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "007622",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Saybrook, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.