Provider Demographics
NPI:1578822896
Name:LYONS, GREGORY (LMHC, CAP, ICADC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:LYONS
Suffix:
Gender:M
Credentials:LMHC, CAP, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NORTH FLORIDA MANGO RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:561-296-5288
Mailing Address - Fax:561-296-5287
Practice Address - Street 1:2200 NORTH FLORIDA MANGO RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-296-5288
Practice Address - Fax:561-296-5287
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4881101YA0400X
FLMH9218101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health