Provider Demographics
NPI:1033280714
Name:LYONS, MARY ANN (LMFT, CMHS)
Entity Type:Individual
Prefix:MS
First Name:MARY ANN
Middle Name:
Last Name:LYONS
Suffix:
Gender:F
Credentials:LMFT, CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 227TH PL SW
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-9453
Mailing Address - Country:US
Mailing Address - Phone:425-488-3882
Mailing Address - Fax:425-482-2392
Practice Address - Street 1:17544 MIDVALE AVE N
Practice Address - Street 2:SUITE 206
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4921
Practice Address - Country:US
Practice Address - Phone:206-240-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00000993106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist