Provider Demographics
NPI:1740048552
Name:LYON, MADELINE (MS, LAMFT)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:LYON
Suffix:
Gender:
Credentials:MS, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7227 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5251
Mailing Address - Country:US
Mailing Address - Phone:480-442-6356
Mailing Address - Fax:
Practice Address - Street 1:7227 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5251
Practice Address - Country:US
Practice Address - Phone:480-442-6356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-08107T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1740851542OtherJANUARY HARTZE INDIVIDUAL NPI
AZ125011Medicaid
AZ1043982747OtherHEALING HARTZE ORGANIZATION NPI
AZCSLG13231OtherAZDHS