Provider Demographics
NPI:1619326626
Name:LYONS, CATHLEEN (MFT)
Entity Type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:
Last Name:LYONS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:CASS
Other - Middle Name:
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:17000 VENTURA BLVD STE 317
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4164
Mailing Address - Country:US
Mailing Address - Phone:818-990-1989
Mailing Address - Fax:
Practice Address - Street 1:17000 VENTURA BLVD STE 317
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4164
Practice Address - Country:US
Practice Address - Phone:818-990-1989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT29134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health