Provider Demographics
NPI:1972651131
Name:LYON, ANN FORSTER (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:FORSTER
Last Name:LYON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 E LANSING DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-7785
Mailing Address - Country:US
Mailing Address - Phone:517-332-2275
Mailing Address - Fax:
Practice Address - Street 1:1451 E LANSING DR
Practice Address - Street 2:SUITE 215
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-7785
Practice Address - Country:US
Practice Address - Phone:517-332-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010017431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0890175Medicare ID - Type Unspecified