Provider Demographics
NPI:1558883538
Name:LYDICK, SONYA HARSHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:HARSHA
Last Name:LYDICK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SONYA
Other - Middle Name:
Other - Last Name:BAER-HARSHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:4500 CLEARVIEW PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2351
Mailing Address - Country:US
Mailing Address - Phone:504-885-1442
Mailing Address - Fax:504-885-1441
Practice Address - Street 1:4500 CLEARVIEW PKWY STE 201
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2351
Practice Address - Country:US
Practice Address - Phone:504-885-1442
Practice Address - Fax:504-885-1441
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1566103TC2200X
NE5166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health