Provider Demographics
NPI:1174002802
Name:CRAIGMYLE, LYDIA SPALDING (PHD)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:SPALDING
Last Name:CRAIGMYLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 80TH ST APT 29A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0646
Mailing Address - Country:US
Mailing Address - Phone:212-772-6827
Mailing Address - Fax:
Practice Address - Street 1:280 PARK AVE S APT 17L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6132
Practice Address - Country:US
Practice Address - Phone:212-254-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012252-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist