Provider Demographics
NPI:1356819429
Name:LYONS, LEAH ROSE (MSW)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:ROSE
Last Name:LYONS
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 1:15529 THISTLEBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3292
Mailing Address - Country:US
Mailing Address - Phone:301-467-1065
Mailing Address - Fax:
Practice Address - Street 1:1500 FRANKLIN ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2000
Practice Address - Country:US
Practice Address - Phone:301-467-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD184911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical