Individual
LYDIA ANNA BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, MAC
Contact information
Practice address
379 W KATMAI AVE, SOLDOTNA, AK 99669-7315
(907) 953-9655
Mailing address
379 W KATMAI AVE, SOLDOTNA, AK 99669-7315
(907) 953-9614
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
109622
AK
101YM0800X
Mental Health Counselor
109622
AK
101YP2500X
Professional Counselor
Primary
109622
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109622
LICENSED PROFESSIONAL COUNSELOR
AK
Enumeration date
06/04/2017
Last updated
11/06/2021
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