Provider Demographics
NPI:1730251935
Name:STYCZYNSKI, LYN E (PHD)
Entity type:Individual
Prefix:DR
First Name:LYN
Middle Name:E
Last Name:STYCZYNSKI
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 1:106 WILDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6224
Mailing Address - Country:US
Mailing Address - Phone:781-641-2210
Mailing Address - Fax:781-648-4717
Practice Address - Street 1:173 MT AUBURN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4005
Practice Address - Country:US
Practice Address - Phone:781-641-2210
Practice Address - Fax:781-648-4777
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2320103TC0700X, 103TF0000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1898655Medicaid
MA0005140246OtherAETNA PIN
MA0005140246OtherAETNA PIN
MAW02461Medicare ID - Type Unspecified