Provider Demographics
NPI:1205246675
Name:PATTERSON, LYDIA (LMHC)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:MOJKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:279 BRICK KILN RD
Mailing Address - Street 2:
Mailing Address - City:TEATICKET
Mailing Address - State:MA
Mailing Address - Zip Code:02536-5651
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:279 BRICK KILN RD
Practice Address - Street 2:
Practice Address - City:TEATICKET
Practice Address - State:MA
Practice Address - Zip Code:02536-5651
Practice Address - Country:US
Practice Address - Phone:508-388-7613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11295101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health