Provider Demographics
NPI:1144565607
Name:KASMOCH, LYDIA ANNE (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:ANNE
Last Name:KASMOCH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MS
Other - First Name:LYDIA
Other - Middle Name:ANNE
Other - Last Name:KASMOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 N. CAMPBELL ST.
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902
Mailing Address - Country:US
Mailing Address - Phone:915-999-9540
Mailing Address - Fax:915-247-2025
Practice Address - Street 1:710 N. CAMPBELL ST.
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902
Practice Address - Country:US
Practice Address - Phone:915-999-9540
Practice Address - Fax:915-247-2025
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health