Provider Demographics
NPI:1114321999
Name:BOWMAN-LYDY COUNSELING,LLC
Entity Type:Organization
Organization Name:BOWMAN-LYDY COUNSELING,LLC
Other - Org Name:WENDY LYDY, MSED, LPC,LSC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LYDY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:614-905-7618
Mailing Address - Street 1:1259 STATE ROUTE 203
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9759
Mailing Address - Country:US
Mailing Address - Phone:740-815-7523
Mailing Address - Fax:
Practice Address - Street 1:1259 STATE ROUTE 203
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9759
Practice Address - Country:US
Practice Address - Phone:740-815-7523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0700124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty