Provider Demographics
NPI:1174563159
Name:LYDON, KAREN MARIE SR (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:LYDON
Suffix:SR
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406-1321
Mailing Address - Country:US
Mailing Address - Phone:717-755-7431
Mailing Address - Fax:
Practice Address - Street 1:214 W MARKET ST
Practice Address - Street 2:
Practice Address - City:HELLAM
Practice Address - State:PA
Practice Address - Zip Code:17406-1029
Practice Address - Country:US
Practice Address - Phone:717-755-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0233001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101085730Medicaid