Provider Demographics
NPI:1518591825
Name:LYDON, NICHOLA (LCSW, CPRS)
Entity Type:Individual
Prefix:
First Name:NICHOLA
Middle Name:
Last Name:LYDON
Suffix:
Gender:F
Credentials:LCSW, CPRS
Other - Prefix:MRS
Other - First Name:NICHOLA
Other - Middle Name:
Other - Last Name:LYDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Mailing Address - Street 2:492 ROUTE 57 WEST
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4411
Mailing Address - Country:US
Mailing Address - Phone:908-689-1000
Mailing Address - Fax:908-689-4529
Practice Address - Street 1:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Practice Address - Street 2:370 MEMORIAL PARKWAY
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1580
Practice Address - Country:US
Practice Address - Phone:908-454-4470
Practice Address - Fax:908-454-5317
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NJ44SL06606100104100000X
NJ44SC062714001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker