| Stonington Psychology Llc | |
|
107 Wilcox Rd Suite 107-e Stonington CT 06378-2614 | |
| (860) 245-9222 | |
| (860) 535-9891 |
| Full Name | Stonington Psychology Llc |
|---|---|
| Speciality | Psychologist |
| Location | 107 Wilcox Rd, Stonington, Connecticut |
| Authorized Official Name and Position | Linda Suriyakham (OWNER) |
| Authorized Official Contact | 8602459222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonington Psychology Llc 107 Wilcox Rd Suite 107-e Stonington CT 06378-2614 Ph: (860) 245-9222 | Stonington Psychology Llc 107 Wilcox Rd Suite 107-e Stonington CT 06378-2614 Ph: (860) 245-9222 |
| NPI Number | 1659627453 |
|---|---|
| Provider Enumeration Date | 07/30/2012 |
| Last Update Date | 07/30/2012 |
| Medicare PECOS PAC ID | 6204051931 |
|---|---|
| Medicare Enrollment ID | O20140714000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659627453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 003158 (Connecticut) | Primary |
| Provider Name | Linda Suriyakham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720354491 PECOS PAC ID: 7012132749 Enrollment ID: I20140714000126 |
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