Lydia Home Association

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LYDIA HOME ASSOCIATION

Practice address

4300 W Irving Park Rd #B
Counseling Center
Chicago, IL 60641-2825

Phone

(773) 736-1447

Fax

(773) 736-6970

NPI assigned

Apr 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David K. Anderson, PSY D

Title

Executive Director

Phone

(773) 736-1447

Specialties & licenses 8

Addresses

Tax ID family

Lydia Home Association4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Lydia Home Association

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Chicago, IL
  • NPI 1235197583
  NPD tax ID
• Lydia Home Association

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Evanston, IL
  • NPI 1962123901
  NPD tax ID
• Lydia Home Association

  • Mental Health Counselor
  • Hillsborough, NJ
  • NPI 1275671513
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1316904956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W IRVING PARK RD",
            "address_2": "COUNSELING CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412825",
            "telephone_number": "773-736-1447",
            "fax_number": "773-736-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W IRVING PARK RD #B",
            "address_2": "COUNSELING CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412825",
            "telephone_number": "773-736-1447",
            "fax_number": "773-736-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIA HOME ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-736-1447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Ly, MD
• Olivia Thao Ly
• Tori Truong Ly, MD
• Noah E Lybik, MD
• Lydia Home Association
• Carrie Lydon, LSW
• Sarah Lydon
• Lyfe Present LLC
• Duane Lyke
• Jemina Lyle

• Adult Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.