Provider Demographics
NPI:1407228505
Name:LYON, EMILY (LISW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LYON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 VICTORY PKWY
Mailing Address - Street 2:STE 500
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2874
Mailing Address - Country:US
Mailing Address - Phone:513-221-2330
Mailing Address - Fax:513-221-8954
Practice Address - Street 1:8559 S MASON MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9381
Practice Address - Country:US
Practice Address - Phone:513-229-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.14511251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical