Healthcare Provider Details

I. General information

NPI: 1821164518
Provider Name (Legal Business Name): LYDIA SAYRE LENNIHAN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYDIA SAYRE LENNIHAN LPCC

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 BUENA VISTA DR SE STE 313
ALBUQUERQUE NM
87106-4291
US

IV. Provider business mailing address

424 BRYN MAWR DR SE
ALBUQUERQUE NM
87106-2206
US

V. Phone/Fax

Practice location:
  • Phone: 505-681-0708
  • Fax: 505-256-5171
Mailing address:
  • Phone: 505-242-3050
  • Fax: 505-256-5171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number93501
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: