Healthcare Provider Details

I. General information

NPI: 1962680132
Provider Name (Legal Business Name): PAUL JOSEPH LYONS M.ED. LMHC/LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2008
Last Update Date: 02/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 RIVERSIDE DR C/O FRIENDS OF CHILDREN
NORTHAMPTON MA
01062-2717
US

IV. Provider business mailing address

PO BOX 222 50 RIVER RD.
LEEDS MA
01053-0222
US

V. Phone/Fax

Practice location:
  • Phone: 413-221-8889
  • Fax: 413-584-7833
Mailing address:
  • Phone: 413-221-8889
  • Fax: 413-584-7833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number776
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3248
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: