Provider Demographics
NPI:1568097160
Name:LYONS, RICHARD E II (LPC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:LYONS
Suffix:II
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 FOWLER LN APT C8
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-3236
Mailing Address - Country:US
Mailing Address - Phone:865-770-3662
Mailing Address - Fax:865-236-1151
Practice Address - Street 1:1200 FOWLER LN APT C8
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-3236
Practice Address - Country:US
Practice Address - Phone:865-770-3662
Practice Address - Fax:865-236-1151
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1225662166Medicaid