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NPI Code Detail

MEDICARE: LYNDSAY RAYNA TYRA LPCC

MEDICARE: LYNDSAY RAYNA TYRA LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor286371KY

General Provider Information

NPI Number : 1184592578
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDSAY RAYNA TYRA LPCC
Provider Business Mailing Address
First Line : 205 ELM ST APT 1
Second Line :
City : BEREA
State : KY
Zip : 40403-1856
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 168 E REYNOLDS RD STE 150
Second Line :
City : LEXINGTON
State : KY
Zip : 40517-1360
Country : US
Telephone Number : 859-212-3180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2025
Last Update Date : 10/30/2025

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