Provider Demographics
NPI:1114676996
Name:MICHELE LYONS, PSY.D., LLC
Entity Type:Organization
Organization Name:MICHELE LYONS, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:774-203-9564
Mailing Address - Street 1:482 SOUTHBRIDGE ST # 312
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-2468
Mailing Address - Country:US
Mailing Address - Phone:774-203-9564
Mailing Address - Fax:
Practice Address - Street 1:482 SOUTHBRIDGE ST # 312
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2468
Practice Address - Country:US
Practice Address - Phone:774-203-9564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty