Individual
MS. LYDIA SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C, CAC-AD
Contact information
Practice address
9199 REISTERSTOWN RD, OWINGS MILLS, MD 21117-4520
(443) 743-9687
Mailing address
421 FALLSWAY, BALTIMORE, MD 21202-4800
(410) 837-5533
(410) 837-2168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
AC0673
MD
104100000X
Social Worker
Primary
23745
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
383841200
—
MD
Enumeration date
11/17/2011
Last updated
10/16/2024
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