| Lydia Place | |
|
1430 North Garden Street Bellingham WA 98226 | |
| (360) 671-7663 | |
| (360) 933-9739 |
| Full Name | Lydia Place |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1430 North Garden Street, Bellingham, Washington |
| Authorized Official Name and Position | Erin Smith (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3606717663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lydia Place Po Box 28487 Bellingham WA 98228 Ph: (360) 671-7663 | Lydia Place 1430 North Garden Street Bellingham WA 98226 Ph: (360) 671-7663 |
| NPI Number | 1508342759 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 03/24/2020 |
| Certification Date | 03/24/2020 |
| Medicare PECOS PAC ID | 9739516352 |
|---|---|
| Medicare Enrollment ID | O20200220001811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508342759 | NPI | - | NPPES |
| Provider Name | Erin P Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932461266 PECOS PAC ID: 0345677969 Enrollment ID: I20200404000297 |
| Provider Name | Holly Camille Martinsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710315601 PECOS PAC ID: 3274971932 Enrollment ID: I20240401003108 |
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