Lynn Suppe, PH.D., LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

03-249962 Issued in CT

Legal business name

LYNN SUPPE, PH.D., LLC

Practice address

1 Bradley Rd
Suite 904
Woodbridge, CT 06525-2285

Phone

(203) 799-9977

Fax

(203) 397-1510

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lynn Suppe, PH.D.

Title

Psychologist

Phone

(203) 799-9977

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801090931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE 904",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252285",
            "telephone_number": "203-799-9977",
            "fax_number": "203-397-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE 904",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252285",
            "telephone_number": "203-799-9977",
            "fax_number": "203-397-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN SUPPE, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUPPE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "203-799-9977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CT",
            "license": "03-249962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Ashley Loran, PMHNP-BC
• Kate Lorenzoni, LCSW
• Kayla Marie Lucas, LCSW
• Julie Luce, LMSW
• Carl B. Lundborg, M.D.
• Leslie Lyons
• Shevonne Natasha Mack-Walker, LMSW
• Marilena Mademtzi, BCBA
• Daniel Magin, RBT
• James Magner, M.D.

• Point of Service in Woodbridge, CT
• Providers in Woodbridge, CT by specialty
• Point of Service in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.