Provider Demographics
NPI:1144781394
Name:HOLGUIN-GAVIRIA, LYDA (LCPC, LMHC, NCC)
Entity type:Individual
Prefix:DR
First Name:LYDA
Middle Name:
Last Name:HOLGUIN-GAVIRIA
Suffix:
Gender:F
Credentials:LCPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 SALISBURY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6187
Mailing Address - Country:US
Mailing Address - Phone:571-336-7952
Mailing Address - Fax:
Practice Address - Street 1:4651 SALISBURY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6107
Practice Address - Country:US
Practice Address - Phone:571-336-7952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC15031101YM0800X
FLMH25656101YM0800X
MDLC8723101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health