Lydia Elyse Shively, ATR-P, LCMHCA
Counselor, Mental Health in Hampstead, NC. Individual provider (NPI-1).
NPI number1174209019
StatusActive
Last updated in NPPESJun 26, 2023
Details
- NPI
- 1174209019
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Lydia Elyse Shively
- Credential
- ATR-P, LCMHCA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 26, 2023
- Certification date
- Jun 26, 2023
- Last updated
- Jun 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | A18504 | NC | Yes |
Practice location
386 Waldorf WayHampstead, NC 28443
Phone 910-707-3505
Mailing address
386 Waldorf WayHampstead, NC 28443
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