Provider Demographics
NPI:1013049535
Name:SANCHEZ, LYDIA C (LBSW)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:C
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 S ENCANTO CIR
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-4423
Mailing Address - Country:US
Mailing Address - Phone:505-546-3632
Mailing Address - Fax:
Practice Address - Street 1:1100 S NICKEL ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-6301
Practice Address - Country:US
Practice Address - Phone:505-546-2678
Practice Address - Fax:505-544-0918
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMB052151041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool