Provider Demographics
NPI:1932522315
Name:MYINT, NYI NYI (LCSWA, LCASA)
Entity Type:Individual
Prefix:
First Name:NYI
Middle Name:NYI
Last Name:MYINT
Suffix:
Gender:M
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 CHILDSBERG WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2083
Mailing Address - Country:US
Mailing Address - Phone:919-609-1557
Mailing Address - Fax:
Practice Address - Street 1:612 CHILDSBERG WAY
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2083
Practice Address - Country:US
Practice Address - Phone:919-609-1557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3437-A101YA0400X
NCP0082051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)