Provider Demographics
NPI:1770861403
Name:LYONS, AMY S (LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:S
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:PO BOX 1868
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-1868
Mailing Address - Country:US
Mailing Address - Phone:307-733-2046
Mailing Address - Fax:307-733-6289
Practice Address - Street 1:290 W KELLY AVE
Practice Address - Street 2:PO BOX 8912
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83002-8912
Practice Address - Country:US
Practice Address - Phone:307-220-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional