Provider Demographics
NPI:1184413148
Name:LYONS, ANGEL BURT
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:BURT
Last Name:LYONS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 ARCHER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-8701
Mailing Address - Country:US
Mailing Address - Phone:252-314-2160
Mailing Address - Fax:
Practice Address - Street 1:424 ARCHER DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-8701
Practice Address - Country:US
Practice Address - Phone:252-314-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker