Provider Demographics
NPI:1750044855
Name:LYON, THOMAS REGIS (LMFT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:REGIS
Last Name:LYON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 HARTNELL RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-4733
Mailing Address - Country:US
Mailing Address - Phone:805-878-4421
Mailing Address - Fax:
Practice Address - Street 1:256 HARTNELL RD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-4733
Practice Address - Country:US
Practice Address - Phone:805-878-4421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-16
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41480106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist