MEDICARE: RICHARD LYON, PH.D., FAMILY THERAPIST, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC28574	CA

General Provider Information

NPI Number	:	1114181583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD LYON, PH.D., FAMILY THERAPIST, INC.

Provider Business Mailing Address
First Line	:	1000 E WALNUT ST
Second Line	:	SUITE 225
City	:	PASADENA
State	:	CA
Zip	:	91106-1452
Country	:	US
Telephone Number	:	818-957-5750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 E WALNUT ST
Second Line	:	SUITE 225
City	:	PASADENA
State	:	CA
Zip	:	91106-1452
Country	:	US
Telephone Number	:	818-957-5750
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD S. LYON
Credential	:	PH.D., M.F.T.
Telephone Number	:	818-957-5750

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	07/15/2008

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