Lydia Anna Bird, LPC, MAC

Individual provider Active NPI Professional Counselor · Soldotna, AK

NPI 1477082410 · NPPES record last updated Nov 6, 2021

Key facts

NPI
1477082410
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
109622 (AK)
Practice address
379 W Katmai Ave
Soldotna, AK 99669-7315
Phone
(907) 953-9655
NPI assigned
Jun 4, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Widening Circles LLC Current
since Nov 16, 2021
Accepting new patients
Wild Goose Counseling LLC Past
since Nov 16, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 109622 AK
Mental Health Counselor 101YM0800X 109622 AK
Professional Counselor 101YP2500X 109622 AK Yes

Addresses

Primary practice location

379 W Katmai Ave
Soldotna, AK 99669-7315

Mailing address

379 W Katmai Ave
Soldotna, AK 99669-7315
Phone (907) 953-9614

Other identifiers

IdentifierTypeStateIssuer
109622OtherAKLICENSED PROFESSIONAL COUNSELOR

Other providers in Soldotna, AK

All providers in Soldotna, AK · Professional Counselor in Alaska

Sources for this page

Verify at the official NPI Registry.