Provider Demographics
NPI:1740431568
Name:ROY, LYDIA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:LYDIA
Other - Middle Name:THIBEAUX
Other - Last Name:ROY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:3921 INDEPENDENCE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3566
Mailing Address - Country:US
Mailing Address - Phone:318-528-8717
Mailing Address - Fax:318-528-8865
Practice Address - Street 1:3921 INDEPENDENCE DR STE 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3566
Practice Address - Country:US
Practice Address - Phone:318-528-8717
Practice Address - Fax:318-528-8865
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health