Provider Demographics
NPI:1376636324
Name:RICHARDS, LYDIA LM (LCSW)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:LM
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25A FIRST PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963
Mailing Address - Country:US
Mailing Address - Phone:207-873-4325
Mailing Address - Fax:207-873-4344
Practice Address - Street 1:25A FIRST PARK DRIVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-5370
Practice Address - Country:US
Practice Address - Phone:207-873-4325
Practice Address - Fax:207-873-4344
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC34491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical