Provider Demographics
NPI:1912524323
Name:HUBBARD, LYDIA (LMSW)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4421
Mailing Address - Country:US
Mailing Address - Phone:443-823-1586
Mailing Address - Fax:
Practice Address - Street 1:1800 N CHARLES ST STE 1600
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5920
Practice Address - Country:US
Practice Address - Phone:410-625-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health