Individual
LYDIA GRACE NELSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
525 PORTLAND AVE # MC963, MINNEAPOLIS, MN 55415-1533
(612) 596-1223
Mailing address
525 PORTLAND AVE # MC963, MINNEAPOLIS, MN 55415-1533
(612) 543-1223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
27972
MN
Other
Enumeration date
01/08/2026
Last updated
01/12/2026
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