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NPI Code Detail

MEDICARE: LYDIA YEATS EGAN

MEDICARE: LYDIA YEATS EGAN
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
1101Y00000XCounselor1902161OH
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1649810615
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA YEATS EGAN
Provider Business Mailing Address
First Line : 6460 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7821
Country : US
Telephone Number : 513-941-4999
Fax Number :
Provider Business Practice Location Address
First Line : 1900 FAIRGROVE AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45011-1966
Country : US
Telephone Number : 317-523-6889
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2020
Last Update Date : 12/01/2025

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Directions to “ LYDIA YEATS EGAN ” Practice Location

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