Healthcare Provider Details

I. General information

NPI: 1144560707
Provider Name (Legal Business Name): RACHEL JO LYON MA, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 CHARLOTTE HWY STE E
ASHEVILLE NC
28803-8681
US

IV. Provider business mailing address

204 CHARLOTTE HWY STE E
ASHEVILLE NC
28803-8681
US

V. Phone/Fax

Practice location:
  • Phone: 828-333-5708
  • Fax: 828-484-1025
Mailing address:
  • Phone: 283-335-7088
  • Fax: 828-484-1025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16603
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: