Healthcare Provider Details

I. General information

NPI: 1770443491
Provider Name (Legal Business Name): WILLIAM NOAH LYONS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W MCCABE ST
STRAFFORD MO
65757-8841
US

IV. Provider business mailing address

PO BOX 7411626
CHICAGO IL
60674-5626
US

V. Phone/Fax

Practice location:
  • Phone: 417-736-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025047472
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: