Lyfes New Direction

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C2009212000082 Issued in NC

Legal business name

LYFES NEW DIRECTION

Practice address

1001 S Marshall St # 65
Winston Salem, NC 27101-5852

Phone

(336) 721-4261

Fax

(336) 721-4265

NPI assigned

Aug 28, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Judith A Bagley

Title

Organizer

Phone

(336) 721-4261

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1003049685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S MARSHALL ST # 65",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015852",
            "telephone_number": "336-721-4261",
            "fax_number": "336-721-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S MARSHALL ST # 65",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015852",
            "telephone_number": "336-721-4261",
            "fax_number": "336-721-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYFES NEW DIRECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "BAGLEY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "336-721-4261",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "C2009212000082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Lyda, PHARMD
• Brittany Autumn Lyda
• Victoria Jane Lydon, MSW, LCSW
• Elizabeth Susan Lyerly, PA-C
• Mark Andrew Lyerly, MD
• Earl Jr Lyles
• Mary Fennell Lyles, MD
• Lyn P. Carpenter, PH.D., PLLC
• Ashley Lynch
• Dennis John Lynch, PH.D.

• Community/Behavioral Health Agency in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.