Provider Demographics
NPI:1639494180
Name:LYONS, ANJALI JAIN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ANJALI
Middle Name:JAIN
Last Name:LYONS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 THE LN
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2477
Mailing Address - Country:US
Mailing Address - Phone:630-391-1127
Mailing Address - Fax:
Practice Address - Street 1:512 W BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2221
Practice Address - Country:US
Practice Address - Phone:630-391-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-27
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490121131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical