Provider Demographics
NPI:1144308008
Name:FLYNN, DENISE A (MSN, PMHCNS-BC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MSN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34950 CHARDON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9162
Mailing Address - Country:US
Mailing Address - Phone:440-510-5100
Mailing Address - Fax:440-510-5151
Practice Address - Street 1:34950 CHARDON RD STE 202
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9162
Practice Address - Country:US
Practice Address - Phone:440-510-5100
Practice Address - Fax:440-510-5151
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN03262364SP0808X
OHRN122363CTP03262RX163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0058245Medicaid
FLNS00875Medicare ID - Type Unspecified