Provider Demographics
NPI:1417484049
Name:MAJORS-ROLAND, LYDIA (LPCC)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:MAJORS-ROLAND
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4826 CHICAGO AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1055
Mailing Address - Country:US
Mailing Address - Phone:612-827-3028
Mailing Address - Fax:612-823-4993
Practice Address - Street 1:4826 CHICAGO AVE STE 105
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-1055
Practice Address - Country:US
Practice Address - Phone:612-827-3028
Practice Address - Fax:612-823-4993
Is Sole Proprietor?:No
Enumeration Date:2017-05-14
Last Update Date:2017-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01474101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional