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NPI Code Detail

MEDICARE: DR. MICHAEL CAREY LYONS PH.D.

MEDICARE: DR. MICHAEL CAREY LYONS PH.D.
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
1103T00000XPsychologist6301007494MI

General Provider Information

NPI Number : 1902816234
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL CAREY LYONS PH.D.
Provider Business Mailing Address
First Line : 1350 LAMA RD
Second Line :
City : KALAMAZOO
State : MI
Zip : 49008-2805
Country : US
Telephone Number : 269-382-1582
Fax Number :
Provider Business Practice Location Address
First Line : 4328 W MICHIGAN AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-5823
Country : US
Telephone Number : 269-375-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 05/21/2009

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