Provider Demographics
NPI:1215191051
Name:LYON, KIRSTIN O (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KIRSTIN
Middle Name:O
Last Name:LYON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KIRSTIN
Other - Middle Name:O
Other - Last Name:LYON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:27871 BERWICK DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8555
Mailing Address - Country:US
Mailing Address - Phone:831-626-4337
Mailing Address - Fax:831-626-8572
Practice Address - Street 1:27871 BERWICK DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8555
Practice Address - Country:US
Practice Address - Phone:831-626-4337
Practice Address - Fax:831-626-8572
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33530106H00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No174400000XOther Service ProvidersSpecialist