Provider Demographics
NPI:1275758807
Name:LYERLY COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:LYERLY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-639-9973
Mailing Address - Street 1:523 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-5408
Mailing Address - Country:US
Mailing Address - Phone:704-639-9973
Mailing Address - Fax:704-639-0869
Practice Address - Street 1:523 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5408
Practice Address - Country:US
Practice Address - Phone:704-639-9973
Practice Address - Fax:704-639-0869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005004101YA0400X
NCC002244101YM0800X
NCC000802106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003819Medicaid
NC6003819Medicaid