Basic Information
| Provider Information | |||||||||
| NPI: | 1386695799 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHNEEBERG | ||||||||
| FirstName: | LYNELLE | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | GAYLORD FARMS RD. | ||||||||
| Address2: | PO BOX 400 | ||||||||
| City: | WALLINGFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06492 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032842800 | ||||||||
| FaxNumber: | 2036793598 | ||||||||
| Practice Location | |||||||||
| Address1: | GAYLORD FARMS RD. | ||||||||
| Address2: | |||||||||
| City: | WALLINGFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06492 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032842800 | ||||||||
| FaxNumber: | 2036793598 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 09/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 001943 | CT | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.