ERIC LYAKHOVETSKY


Address: 327 W Saidah Rd, Bloomington, IN 47404-8965
Phone: 3175090451

ERIC LYAKHOVETSKY (NPI# 1134780851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134780851
Entity Type Individual
Full Name ERIC LYAKHOVETSKY
Credential PMHNP-BC
Practice Address 327 W Saidah Rd
Bloomington
IN 47404-8965
Practice Telephone 3175090451
Mailing Telephone 3175090451
Enumeration Date 2019-06-24
Last Update Date 2019-06-24
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
28216197A IN Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
327 W Saidah Rd, Bloomington, IN 474048965 3175090451

Office Location

Street Address 327 W SAIDAH RD
City BLOOMINGTON
State IN
Zip Code 47404-8965

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1770966467 Richard Lawson Counselor 1117 North Jackson Street, Bloomington, IN 47404 2015-06-30
1477952109 Teresa R. Foster Social Worker 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 2014-08-19
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1497079982 Tera Dee Nance Counselor 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 2010-03-26
1962643114 Pathways Counseling Center Community/Behavioral Health 3866 W. Third Street, Bloomington, IN 47404 2009-03-18
1932358595 Catherine Elizabeth Batka Psychologist 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 2008-09-18
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1679684203 Colleen S Odonnell Nurse Practitioner 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 2006-08-31
1558970517 Randy Bargo Nurse Practitioner 3600 N Prow Rd, Bloomington, IN 47404-1616 2020-07-27
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1033768569 Amanda Lavender Nurse Practitioner 727 W 2nd St, Bloomington, IN 47403-2209 2019-09-07
1396215786 Hui Shi Serena Loh Nurse Practitioner 3600 N Prow Rd, Bloomington, IN 47404-1616 2018-11-28
1922583285 Bettina Ervin-rodgers Nurse Practitioner 108 W Market St, Bloomington, IL 61701-3918 2018-10-02
1710479753 Kevin Nelson Moore Nurse Practitioner 550 S Adams St, Bloomington, IN 47403 2018-06-05
1205287513 Stephanie B. Pemberton Nurse Practitioner 3600 N Prow Rd, Bloomington, IN 47404-1616 2016-06-28
1578942348 Brandee Kay Marksberry Nurse Practitioner 445 S Landmark Ave, Bloomington, IN 47403-5004 2015-05-26
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Competitor

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City BLOOMINGTON
Zip Code 47404

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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