Individual ProviderLydia ThreattCounselorBehavioral Health & Social Service ProvidersPractice Address1710 Highway 16 W, Griffin, GA 30223-7107(770) 229-3407PECOS EnrollmentBased on the most recent information from CMS, provider Lydia Threatt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1982187118Provider TypeIndividualFull NameThreatt, LydiaTitleMs.CredentialAPCGenderFemaleSole ProprietorYesEnumeration Date9/13/2018Last Updated9/13/2018Contact InformationPractice LocationPractice Address1710 Highway 16 W, Griffin, GA 30223-7107Phone(770) 229-3407Fax(770) 229-3465Mailing LocationMailing Address1710 Highway 16 W, Griffin, GA 30223-7107Phone(770) 229-3407Fax(770) 229-3465Provider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseAPC006571Georgia