Individual provider Active NPI

Laura Jane Lyke, MA

  • Mental Health Counselor
  • Needham, MA
National Provider Identifier
1952925406
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
255 Highland Ave
Needham, MA 02494-3023
Phone
(781) 247-7762
NPI assigned
Jun 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

255 Highland Ave
Needham, MA 02494-3023

Mailing address

255 Highland Ave
Needham, MA 02494-3023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710004671 MN Practitioner - Mental Health Counselor 5890230171 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4392MNMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthwise Psychology, PA CurrentSince May 14, 2024 Accepting new patients
Riverside Early Intervention PastSince Mar 13, 2022 Accepting new patients
Scott M Yarosh, LLC Mental Health PastSince Dec 15, 2009 Accepting new patients
Riverside Community Care PastSince Mar 13, 2022 Accepting new patients

Locations

11280 86th Ave N
Maple Grove, MN 55369
Phone (763) 400-7828

18205 45th Ave N
Plymouth, MN 55446
Phone (763) 400-7828

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1952925406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943023",
            "telephone_number": "781-247-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYKE",
        "first_name": "LAURA",
        "middle_name": "JANE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

Verify at the official NPI Registry.