Provider Demographics
NPI:1083950059
Name:WILLIAMS, LYDIA LEE (MASTERS COUNSELING)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MASTERS COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 RICHLAND ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6114
Mailing Address - Country:US
Mailing Address - Phone:858-212-6021
Mailing Address - Fax:
Practice Address - Street 1:2725 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2757
Practice Address - Country:US
Practice Address - Phone:619-688-1035
Practice Address - Fax:619-688-1098
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health