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General NPI Number Information
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NPI Number | 1063844645
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Entity Type | Individual
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Provider Name | ANGELA LYON LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 223 N LOCUST ST APT 1
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City | GRAND ISLAND
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State | NE
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Zip | 68801-5930
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Country | US
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Telephone | 308-391-2280
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Fax |
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Provider Business Mailing Address
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Address Line | 223 N LOCUST ST
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City | GRAND ISLAND
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State | NE
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Zip | 68801-5920
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Country | US
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Telephone | 308-392-2280
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Fax | 308-832-4803
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1700
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1772
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License Number State | NE
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