Provider Demographics
NPI:1144787474
Name:BYERS, VIA-TONDA E (LMFT)
Entity Type:Individual
Prefix:
First Name:VIA-TONDA
Middle Name:E
Last Name:BYERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28053-0591
Mailing Address - Country:US
Mailing Address - Phone:704-629-8210
Mailing Address - Fax:866-441-0992
Practice Address - Street 1:625 E 2ND AVE STE 10
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0470
Practice Address - Country:US
Practice Address - Phone:704-629-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2155106H00000X
NC12119A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12119AOtherLICENSE
NC2155OtherLICENSE