Kenin, Lydia

Kenin, Lydia is an sole proprietor health care provider with primary practice located at 45 Metacomet Rd , Waban MA 02468-1418. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Kenin, Lydia can be contacted via phone (617) 969-7393.

Contact Information

Primary practice address
45 Metacomet Rd Waban MA 02468-1418
Phone: (617) 969-7393
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 4186 Massachusetts
Behavioral Health & Social Service Providers / Clinical 1041C0700X 103930 Massachusetts

Profile Details

NPI number 1902042344
LBN Legal business name Kenin, Lydia
Credentials PSYD, LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 6th, 2009
Last updated Jan 6th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902042344 NPPES
Massachusetts Other W50166 MEDICARE PARTICIPATING SUPPLIER IDENTIFICATION CODE
Massachusetts Other WO5557 MEDICARE PARTICIPATING SUPPLIER IDENTIFICATION CODE

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