Lyon, Virginia

Lyon, Virginia is an individual health care provider with primary practice located at 40 Mansfield Ave , Willimantic CT 06226-2018. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Lyon, Virginia can be contacted via phone (860) 450-0585.

Contact Information

Primary practice address
40 Mansfield Ave Willimantic CT 06226-2018
Phone: (860) 450-0585
Fax: (860) 450-0763
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8252 Connecticut

Profile Details

NPI number 1033455365
LBN Legal business name Lyon, Virginia
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2012
Last updated Mar 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033455365 NPPES
Connecticut MEDICAID 004040564

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