MEDICARE: VIYDA LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1952198178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIYDA LLC

Provider Business Mailing Address
First Line	:	PO BOX 2079
Second Line	:
City	:	ROCKY MOUNT
State	:	VA
Zip	:	24151-8379
Country	:	US
Telephone Number	:	540-483-0071
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 E COURT ST STE 301
Second Line	:
City	:	ROCKY MOUNT
State	:	VA
Zip	:	24151-1761
Country	:	US
Telephone Number	:	540-483-0071
Fax Number	:	540-483-0092

Authorized Official
Title or Position	:	OWNER
Name	:	DEANNA LEE DICK
Credential	:	LPC
Telephone Number	:	540-483-0071

Provider Enumeration Date	:	04/22/2025
Last Update Date	:	05/02/2025

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Directions to “VIYDA LLC ” Practice Location

Language	Start Address	Practice Location

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