Provider Demographics
NPI:1699189597
Name:LYONS, DEBRA KAY (LPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:LYONS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N WASHINGTON ST
Mailing Address - Street 2:SUITE 130B
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-1716
Mailing Address - Country:US
Mailing Address - Phone:573-747-7796
Mailing Address - Fax:
Practice Address - Street 1:18701 HISTORIC RTE 66
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-6306
Practice Address - Country:US
Practice Address - Phone:636-438-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005038669101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional