Provider Demographics
NPI:1508530486
Name:MCNAMARA, LYDIA ELIZABETH (LCSW-A)
Entity Type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:ELIZABETH
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 APRIL LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3706
Mailing Address - Country:US
Mailing Address - Phone:980-339-1578
Mailing Address - Fax:
Practice Address - Street 1:3705 LATROBE DR STE 340
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4823
Practice Address - Country:US
Practice Address - Phone:704-364-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0166181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical