Miriam Reishun Lyde, LCMHC,LCAS-P

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

820 Grimes Blvd
Lexington, NC 27292-7640

Phone

(336) 224-6071

Fax

(336) 224-6393

NPI assigned

Jul 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1194080622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 GRIMES BLVD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272927640",
            "telephone_number": "336-224-6071",
            "fax_number": "336-224-6393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Kimel Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036951",
            "country_code": "US",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-6981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYDE",
        "first_name": "MIRIAM",
        "middle_name": "REISHUN",
        "credential": "LCMHC,LCAS-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "LPCA11494",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Morgan Lott, PA-C
• Jamie L Lowe
• Katie Lowman, RN
• Shane Lu, DDS
• Jordan Watford Lupton
• Wendy Michelle Lyerly, RN
• M Medical NC PLLC
• Kelli Claire Mackie, OTR/L
• Nwannedimma Onyekachi Maduabum
• Philip Andrew Mahan, D.C.

• Addiction (Substance Use Disorder) Counselor in Lexington, NC
• Providers in Lexington, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.