Provider Demographics
NPI:1568508463
Name:BROWN, LYDIA KATHRYN (LPC)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:KATHRYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 SHADY MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1233
Mailing Address - Country:US
Mailing Address - Phone:281-913-2687
Mailing Address - Fax:
Practice Address - Street 1:2916 W T C JESTER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-7051
Practice Address - Country:US
Practice Address - Phone:713-263-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83534LOtherBLUE CROSS BLUE SHIELD