Lysha Erin Wood, M.A.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007168 Issued in GA

Practice address

1015 Tyrone Rd Ste 710
Tyrone, GA 30290-2455

Phone

(770) 468-3266

NPI assigned

Aug 29, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• We Are Back on Track LLC

  • Professional Counselor
  • Tyrone, GA
  • NPI 1205204294
  NPD Authorized official

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1689922296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 TYRONE RD STE 710",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902455",
            "telephone_number": "770-468-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 TYRONE RD STE 710",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902455",
            "telephone_number": "770-468-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "LYSHA",
        "middle_name": "ERIN",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WV",
            "license": "2043",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005489001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005489002",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor R Williamson, OD
• Zachary Scott Williamson, OD
• Hannah Wilson, RBT
• Mariah Wilson
• WMC Tyrone LLC
• Spencer Wood, LPC
• John Arthur Woolf, ATC
• Jermaine Woolfolk
• Dongjin Yoon, MD

• Professional Counselor in Tyrone, GA
• Providers in Tyrone, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.