Provider Demographics
NPI:1811425044
Name:SILVA-BOSCHETTI, LYDIA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:
Last Name:SILVA-BOSCHETTI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9225
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-9225
Mailing Address - Country:US
Mailing Address - Phone:1787-787-0000
Mailing Address - Fax:
Practice Address - Street 1:1111 CALLE 1
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5134
Practice Address - Country:US
Practice Address - Phone:787-397-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health