MEDICARE: LYDIA NACE SUITT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC-24328	AZ

General Provider Information

NPI Number	:	1164279915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA NACE SUITT LPC

Provider Business Mailing Address
First Line	:	1200 N EL DORADO PL STE A-150
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85715-4637
Country	:	US
Telephone Number	:	520-366-8195
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N EL DORADO PL STE A-150
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85715-4637
Country	:	US
Telephone Number	:	520-366-8195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	01/23/2026

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