Eric Lyakhovetsky, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

28216197A Issued in IN

Practice address

327 W Saidah Rd
Bloomington, IN 47404-8965

Phone

(317) 509-0451

NPI assigned

Jun 24, 2019

Last updated

Jun 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bloomington Meadows GP

  • Family Nurse Practitioner
  • Bloomington, IN
  • NPI 1033298120
  Medicare reassignment NPD
• Midwest Behavioral Health LLC

  dba dba LifeStance Health

  • Psychiatry Physician
  • Evansville, IN
  • NPI 1427362201
  Medicare reassignment NPD

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1134780851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 W SAIDAH RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474048965",
            "telephone_number": "317-509-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 W SAIDAH RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474048965",
            "telephone_number": "317-509-0451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 W Saidah Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474048965",
            "country_code": "US",
            "telephone_number": "317-509-0451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYAKHOVETSKY",
        "first_name": "ERIC",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28216197A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Elizabeth Lupov, M.D.
• Nicholas Luse
• Whitney Lane Lutz, COTA
• Luxottica of America Inc. (Lenscrafters #347)
• Luxottica Retail North America Inc (Pearle Vision #C6313)
• Lillian Marie Lyle, RN
• Alexis Lynch
• Eric Christopher Lynch
• Erin Elizabeth Lynch, AUD, PHD
• Melissa Ann Lynch, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.