Provider Demographics
NPI:1093580243
Name:LYDIA T. ROY
Entity Type:Organization
Organization Name:LYDIA T. ROY
Other - Org Name:LYDIA ROY, LPC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-528-8717
Mailing Address - Street 1:3921 INDEPENDENCE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3566
Mailing Address - Country:US
Mailing Address - Phone:318-528-8717
Mailing Address - Fax:
Practice Address - Street 1:3921 INDEPENDENCE DR STE 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3566
Practice Address - Country:US
Practice Address - Phone:318-528-8717
Practice Address - Fax:318-528-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty