Healthcare Provider Details

I. General information

NPI: 1780024463
Provider Name (Legal Business Name): SYLVIA LYEW LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 YONKERS RD
RALEIGH NC
27604-2258
US

IV. Provider business mailing address

5011 EVERGREEN FOREST WAY APT 207
RALEIGH NC
27616-7906
US

V. Phone/Fax

Practice location:
  • Phone: 919-896-7536
  • Fax:
Mailing address:
  • Phone: 718-344-7805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA10041
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: