Provider Demographics
NPI:1972867109
Name:LYON, ASHLEY JANE-MARIE (MA, LPC, ATR)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JANE-MARIE
Last Name:LYON
Suffix:
Gender:F
Credentials:MA, LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 MALLOW ST
Mailing Address - Street 2:
Mailing Address - City:WOLVERINE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-1934
Mailing Address - Country:US
Mailing Address - Phone:734-718-2261
Mailing Address - Fax:
Practice Address - Street 1:1251 MALLOW ST
Practice Address - Street 2:
Practice Address - City:WOLVERINE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48390-1934
Practice Address - Country:US
Practice Address - Phone:734-718-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013124101Y00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor