MIRIAM REISHUN LYDE (NPI# 1194080622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194080622 |
| Entity Type | Individual |
| Full Name | MIRIAM REISHUN LYDE |
| Credential | LCMHC,LCAS-P |
| Practice Address |
820 Grimes Blvd Lexington NC 27292-7640 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 3362246071 |
| Practice Fax Number | 3362246393 |
| Mailing Telephone | 3367183550 |
| Mailing Fax Number | 3362776981 |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2020-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
LPCA11494 | NC | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 175 Kimel Park Dr Ste 100, Winston Salem, NC 271036951 | 3367183550 | 3362776981 |
| Street Address |
820 GRIMES BLVD |
| City | LEXINGTON |
| State | NC |
| Zip Code | 27292-7640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114946985 | Janet Taxis Rogers | Counselor | 820 Grimes Blvd, Foundations Behavioral Services, Lexington, NC 27292 | 2006-07-19 |
| 1629696125 | Shereka Dabney | Prevention Professional | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2020-07-10 |
| 1760948814 | Susan Dee Gingher | Counselor | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2019-02-13 |
| 1568940773 | Fontasia Monique Wade-blivens | Social Worker | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2018-07-31 |
| 1235639766 | Orien Ray Medley | Counselor | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2018-02-21 |
| 1609307065 | Lafonda Lewis Bruinton | Counselor | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2017-03-27 |
| 1003163213 | Keren Williams | Counselor | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2012-08-07 |
| 1841551413 | Shaina Danae Whitley | Licensed Practical Nurse | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2012-05-31 |
| 1497063937 | Alex Goldstein | Social Worker | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2010-09-17 |
| 1184940298 | Monarch | Community/Behavioral Health | 820 Grimes Blvd, Lexington, NC 27292-7640 | 2010-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619510021 | Alexander Youth Network | Community/Behavioral Health | 398 Owen Road, Rooms #616 & 618, Lexington, NC 27292 | 2019-10-18 |
| 1669911202 | Suzanne Rose Troy | Counselor | 110-a Cotton Grove Rd., Lexington, NC 27292 | 2017-02-15 |
| 1467908095 | Careatc - Leggett & Platt - Lexington, Nc | Clinic/Center | 3040 Junior Order Home Road, Lexington, NC 27292 | 2016-09-01 |
| 1437517182 | Regional Physicians LLC | Internal Medicine | 103 W Center St, Lexington, NC 27292 | 2016-02-09 |
| 1356772065 | Medstaffpc | Family Medicine | 3040 Junior Order Home Rd, Lexington, NC 27292 | 2013-12-05 |
| 1427306570 | Lisa Anne Kearns | Pharmacist | 880 Ervin Dr, Lexington, NC 27292 | 2012-08-21 |
| 1669756979 | Beth A Burns | Counselor | 19 E 2nd Ave Ste C, Lexington, NC 27292 | 2011-10-05 |
| 1629256185 | Holly Ann Clark | Counselor | 220 E First Ave Extension, Lexington, NC 27292 | 2008-02-07 |
| 1861675357 | High Rock Internal Medicine, Pa | Internal Medicine | 104 W. Medical Park Dr., Lexington, NC 27292 | 2007-12-07 |
| 1225229214 | Beatriz R. Aguero, Dds & Associates Iv, Pa | Dentist | 230 Lowes Blvd, Leexington, NC 27292 | 2007-08-06 |
| Find all providers in zip 27292 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285252080 | Shamara Huguely | Counselor | 455 Park Pl # 130, Lexington, KY 40511-1881 | 2020-07-08 |
| 1396373304 | Serenity Keepers | Counselor | 2033 Daniel Ct Apt 1, Lexington, KY 40504-1837 | 2020-03-27 |
| 1205482619 | Laura K. Wampler | Counselor | 423 Woodsway Dr, Lexington, NC 27292-4655 | 2019-08-12 |
| 1033677505 | Alyssa May Tremblay | Counselor | 389 Waller Ave Fl 2, Lexington, KY 40504-2900 | 2019-03-04 |
| 1992278915 | Amy H Ward | Counselor | 1382 Bull Lea Road, Lexington, KY 40511 | 2019-01-03 |
| 1447745922 | Christopher Todd Cox | Counselor | 149 Deweese St, Lexington, KY 40507-1925 | 2018-06-26 |
| 1023503919 | Kimberly Kelly | Counselor | 1382 Bull Lea Rd, Lexington, KY 40511-1247 | 2018-06-25 |
| 1528566114 | Alteri, LLC | Counselor | 1517 Nicholasville Rd Ste 402, Lexington, KY 40503 | 2018-01-29 |
| 1700390218 | Courtney Nicole Shields | Counselor | 201 Mechanic St Fl 1, Lexington, KY 40507-1086 | 2017-11-20 |
| 1982134409 | Amy Beth Powers | Counselor | 455 Park Place, Suite 130, Lexington, KY 40511 | 2017-06-18 |
| Find all providers in LEXINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.