Holly Lyles
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Brentwood, NH
NPI 1639714579 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1639714579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 074710-23 (NH)
- Practice address
- 2 Greenleaf Cir
Brentwood, NH 03833-6429 - Phone
- (603) 686-4987
- NPI assigned
- Nov 14, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
217 Waverley Rd
North Andover, MA 01845-3534
Phone (603) 686-4987
97 Lincoln St
Apt a
Dover Foxcroft, ME 04426-1329
97 Lincoln St Apt a
Dover Foxcroft, ME 04426-1332
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NH, MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201105002633 | NH | Practitioner - Nurse Practitioner | 9234549015 | Reassigns benefits to 1 organization |
| I20251201000005 | MA | Practitioner - Nurse Practitioner | 9234549015 | Practice locations: North Andover, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 074710-21 | NH | MD | Registered Nurse |
| 074710-23 | NH | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lamora Psychological Associates, P.a. | Current |
Accepting new patients |
Locations
39 Simon St
Ste 5
Nashua, NH 03060
Phone (603) 598-5400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 074710-23 | NH | Yes |
| Registered Nurse | 163W00000X | 074710-21 | NH |
Addresses
Primary practice location
2 Greenleaf Cir
Brentwood, NH 03833-6429
Mailing address
217 Waverley Rd
North Andover, MA 01845-3534
Phone (603) 686-4987
Other practice location 1
217 Waverley Rd
North Andover, MA 01845-3534
Phone (603) 686-4987
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020000589 | Other | NH | ANCC |
Other providers in Brentwood, NH
- Sarah Anne Kelley
- Holly Lynn Lemerise
- Live Free Recovery Consultants LLC
- Cheryl Helen Lord
- Joan Vern Lucca
- Tracy Monterisi
- Paul Nicol
- Debra Jean O'Connor
- Sarah Polcaro
- Power Up Physical Therapy & Fitness
All providers in Brentwood, NH · Psychiatric/Mental Health Nurse Practitioner in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.