| Lynn R Capone Psyd Llc | |
|
2875 W Elm St Lima OH 45805-2510 | |
| (419) 222-5672 | |
| (419) 991-7862 |
| Full Name | Lynn R Capone Psyd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2875 W Elm St, Lima, Ohio |
| Authorized Official Name and Position | Lynn R Capone (OWNER) |
| Authorized Official Contact | 4192225672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynn R Capone Psyd Llc 2875 W Elm St Lima OH 45805-2510 Ph: () - | Lynn R Capone Psyd Llc 2875 W Elm St Lima OH 45805-2510 Ph: (419) 222-5672 |
| NPI Number | 1982110862 |
|---|---|
| Provider Enumeration Date | 12/14/2017 |
| Last Update Date | 12/14/2017 |
| Medicare PECOS PAC ID | 4981962958 |
|---|---|
| Medicare Enrollment ID | O20171220002080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982110862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5454 (Ohio) | Primary |
| Provider Name | Lynn R Capone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881675189 PECOS PAC ID: 3274709886 Enrollment ID: I20120103000786 |
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