Provider Demographics
NPI:1477015469
Name:LYONS, JENNA L (BSW)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:L
Last Name:LYONS
Suffix:
Gender:
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 SHADY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-4023
Mailing Address - Country:US
Mailing Address - Phone:262-470-0006
Mailing Address - Fax:
Practice Address - Street 1:74 S. 2ND STREET
Practice Address - Street 2:P.O. BOX 5030
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43058-5030
Practice Address - Country:US
Practice Address - Phone:740-670-8837
Practice Address - Fax:740-670-8993
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst