Provider Demographics
NPI:1134742307
Name:LYON COUNSELING LLC
Entity type:Organization
Organization Name:LYON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LYON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:715-641-0097
Mailing Address - Street 1:1661 HILO AVE N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-5622
Mailing Address - Country:US
Mailing Address - Phone:715-641-0097
Mailing Address - Fax:612-293-9111
Practice Address - Street 1:3564 ROLLING VIEW DR STE D
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-7003
Practice Address - Country:US
Practice Address - Phone:612-314-6956
Practice Address - Fax:612-293-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01815OtherBOARD OF BEHAVIORAL HEALTH AND THERAPY