Provider Demographics
NPI:1720830557
Name:MAY, LYDIA (LCSW)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:MAY
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 CANAL ST APT 202
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-3275
Mailing Address - Country:US
Mailing Address - Phone:401-648-7471
Mailing Address - Fax:
Practice Address - Street 1:116 BELMONT ST RM 44
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2964
Practice Address - Country:US
Practice Address - Phone:508-219-7189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230351104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker