Individual provider · Type 1 NPI

Lydia M. Staten, LCSW

Mental Health Counselor · Jackson, MS

NPI number 1679788616 Active

Practice location

1225 N West St
Jackson, MS 39202-2056

Call (601) 540-7105 Map

Mailing address

1820 Highway 80 West
Jackson, MS 39204-2056

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XC0715 (MS)

Mental Health Counselor: Definition to come...

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About NPI 1679788616

Lydia M. Staten, LCSW's National Provider Identifier is 1679788616, issued on May 12, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jackson, MS. The record was last updated on May 25, 2012.