Provider Demographics
NPI:1144781394
Name:HOLGUIN PALACIOS, LYDA EUGENIA (LCPC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LYDA
Middle Name:EUGENIA
Last Name:HOLGUIN PALACIOS
Suffix:
Gender:F
Credentials:LCPC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6418 WHITE PEACH PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4472
Mailing Address - Country:US
Mailing Address - Phone:267-290-8612
Mailing Address - Fax:
Practice Address - Street 1:1755 S ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6107
Practice Address - Country:US
Practice Address - Phone:202-234-7738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC15031101YM0800X
MDLC8723101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health