Provider Demographics
NPI:1215013438
Name:LYRENE, BARBARA ANN (MSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:LYRENE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 ASSUNTA COURT
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532
Mailing Address - Country:US
Mailing Address - Phone:251-928-6292
Mailing Address - Fax:251-928-2250
Practice Address - Street 1:7525 ASSUNTA COURT
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532
Practice Address - Country:US
Practice Address - Phone:251-928-6292
Practice Address - Fax:251-928-2250
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPIP2390994C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051031659OtherBLUE CROSS
AL000031659Medicare PIN
AL051031659OtherBLUE CROSS