Individual
MS. LYDIA ALPHA MABBITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
(573) 686-1029
Mailing address
PO BOX 280, POPLAR BLUFF, MO 63902-0280
(573) 686-1200
(573) 686-1029
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2000158656
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013024454
BLUE CROSS BLUE SHIELD
—
01
—
11784624
CAQH
MO
01
—
2613
EAP IMPACT
MO
01
—
431116734
EAP INTERFACE
—
05
—
494997521
—
MO
01
—
890435
HEALTHLINK PPO
MO
01
—
9877
FEI BEHAVIORAL
MO
Enumeration date
08/23/2006
Last updated
04/21/2009
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