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General NPI Number Information
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NPI Number | 1013998046
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Entity Type | Individual
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Provider Name | LYDIA ANN GADD LPCC S
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24500 CENTER RIDGE RD # 100
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City | WESTLAKE
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State | OH
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Zip | 44145-5601
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Country | US
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Telephone | 440-899-1300
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Fax | 440-899-0266
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Provider Business Mailing Address
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Address Line | 24500 CENTER RIDGE RD # 100
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City | WESTLAKE
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State | OH
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Zip | 44145-5601
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Country | US
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Telephone | 440-899-1300
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Fax | 440-899-0266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E2075
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License Number State | OH
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