Provider Demographics
NPI:1063807816
Name:BEST, LYSHA ANISE (LCAS-A)
Entity type:Individual
Prefix:
First Name:LYSHA
Middle Name:ANISE
Last Name:BEST
Suffix:
Gender:F
Credentials:LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5880 LOCH RAVEN POINTE LOOP
Mailing Address - Street 2:APT 104
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-9672
Mailing Address - Country:US
Mailing Address - Phone:704-208-7496
Mailing Address - Fax:
Practice Address - Street 1:215 WILLIAM PENN PLZ
Practice Address - Street 2:APT 1323
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2545
Practice Address - Country:US
Practice Address - Phone:704-208-7496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21339101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)