Healthcare Provider Details

I. General information

NPI: 1952198178
Provider Name (Legal Business Name): VIYDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E COURT ST STE 301
ROCKY MOUNT VA
24151-1761
US

IV. Provider business mailing address

PO BOX 2079
ROCKY MOUNT VA
24151-8379
US

V. Phone/Fax

Practice location:
  • Phone: 540-483-0071
  • Fax: 540-483-0092
Mailing address:
  • Phone: 540-483-0071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DEANNA LEE DICK
Title or Position: OWNER
Credential: LPC
Phone: 540-483-0071