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NPI Code Detail

MEDICARE: LYDIA MAJORS-ROLAND LPCC

MEDICARE: LYDIA MAJORS-ROLAND LPCC
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
1101YP2500XProfessional CounselorCC01474MN

General Provider Information

NPI Number : 1417484049
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA MAJORS-ROLAND LPCC
Provider Business Mailing Address
First Line : 4826 CHICAGO AVE STE 105
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-1055
Country : US
Telephone Number : 612-827-3028
Fax Number : 612-823-4993
Provider Business Practice Location Address
First Line : 4826 CHICAGO AVE STE 105
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-1055
Country : US
Telephone Number : 612-827-3028
Fax Number : 612-823-4993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2017
Last Update Date : 05/14/2017

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Directions to “ LYDIA MAJORS-ROLAND LPCC” Practice Location

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