| Lydia P Perry Lpc Ladc | |
|
1 Fort Hill Rd Ste 6 Groton CT 06340-4799 | |
| (860) 705-9630 | |
| Not Available |
| Full Name | Lydia P Perry Lpc Ladc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1 Fort Hill Rd Ste 6, Groton, Connecticut |
| Authorized Official Name and Position | Sue Roach (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8603687092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lydia P Perry Lpc Ladc 12 Water St Apt 304 Mystic CT 06355-2534 Ph: (860) 705-9630 | Lydia P Perry Lpc Ladc 1 Fort Hill Rd Ste 6 Groton CT 06340-4799 Ph: (860) 705-9630 |
| NPI Number | 1770249880 |
|---|---|
| Provider Enumeration Date | 11/12/2021 |
| Last Update Date | 01/14/2023 |
| Certification Date | 01/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770249880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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