Provider Demographics
NPI:1225373582
Name:HILL-GRANT, LYDIA (MPA, MA, PC)
Entity Type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:
Last Name:HILL-GRANT
Suffix:
Gender:F
Credentials:MPA, MA, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13125 SHAKER SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2399
Mailing Address - Country:US
Mailing Address - Phone:216-307-6328
Mailing Address - Fax:
Practice Address - Street 1:13125 SHAKER SQ STE 101
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2399
Practice Address - Country:US
Practice Address - Phone:216-307-6328
Practice Address - Fax:216-306-5618
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0006346101YP2500X
OHC.0006346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional