Provider Demographics
NPI:1891813549
Name:DYAS, LYNN L (MFT LADC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:L
Last Name:DYAS
Suffix:
Gender:F
Credentials:MFT LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 WONDER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2474
Mailing Address - Country:US
Mailing Address - Phone:775-830-7391
Mailing Address - Fax:775-677-4417
Practice Address - Street 1:260 WONDER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2474
Practice Address - Country:US
Practice Address - Phone:775-830-7391
Practice Address - Fax:775-677-4417
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1067L101YA0400X
NV01028106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507929Medicaid
NV100507928Medicaid
NV100511463Medicaid