Provider Demographics
NPI:1013235209
Name:FINCHAM, LYDA ELIZABETH (MS)
Entity Type:Individual
Prefix:MISS
First Name:LYDA
Middle Name:ELIZABETH
Last Name:FINCHAM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:LYDA
Other - Middle Name:ELIZABETH
Other - Last Name:FINCHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:809 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:KS
Mailing Address - Zip Code:67420-3325
Mailing Address - Country:US
Mailing Address - Phone:785-534-7090
Mailing Address - Fax:
Practice Address - Street 1:113 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:KS
Practice Address - Zip Code:67420-3234
Practice Address - Country:US
Practice Address - Phone:785-534-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS807106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist