| Doctor Name: | DR. LYDIA KENIN |
| NPI Number: | 1902042344 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD, LICSW |
| License Number: | 103930 |
| Business Practice Address: | 45 Metacomet Rd Waban, MA - 024681418 |
| Business Phone Number: | 6179697393 |
| Business Fax Number: | |
| Mailing Address: | 45 Metacomet Rd, WABAN |
| State: | MA |
| Postal Code: | 024681418 |
| Phone Number: | 6179697393 |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2009 |
| NPI Last Update Date: | 01/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 103930 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |