Provider Demographics
NPI:1114181583
Name:RICHARD LYON, PH.D., FAMILY THERAPIST, INC.
Entity Type:Organization
Organization Name:RICHARD LYON, PH.D., FAMILY THERAPIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:LYON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MFT
Authorized Official - Phone:818-957-5750
Mailing Address - Street 1:1000 E WALNUT ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1452
Mailing Address - Country:US
Mailing Address - Phone:818-957-5750
Mailing Address - Fax:
Practice Address - Street 1:1000 E WALNUT ST
Practice Address - Street 2:SUITE 225
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1452
Practice Address - Country:US
Practice Address - Phone:818-957-5750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28574106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty