Kathleen Lydon, LICSW
Individual provider Active NPI Clinical Social Worker · Quincy, MA
NPI 1780187922 · NPPES record last updated Mar 14, 2018
Key facts
- NPI
- 1780187922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 118485 (MA)
- Practice address
- 162 Old Colony Ave
Quincy, MA 02170-3873 - Phone
- (617) 770-4065
- Fax
- (617) 770-2206
- NPI assigned
- Mar 14, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118485 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 118485 | MA | Yes |
Addresses
Primary practice location
162 Old Colony Ave
Quincy, MA 02170-3873
Mailing address
PO Box 690267
Quincy, MA 02269-0267
Phone (617) 770-4065
Other providers in Quincy, MA
- Lux Dental
- Luxe Path Behavioral Health & Wellness PLLC
- Bonnie Ly
- Duc Ly
- Kimberly D Lyder
- Lynn Family Dental and Orthodontics PC
- Lynn Family Dental and Orthodontics PC
- Terence Francis Lynn
- Diana Lyon
- Marietta G Lyon
All providers in Quincy, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.