Basic Information
Provider Information
NPI: 1144560707
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYON
FirstName: RACHEL
MiddleName: JO
NamePrefix:  
NameSuffix:  
Credential: MA, LCMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 204 CHARLOTTE HWY STE E
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288038681
CountryCode: US
TelephoneNumber: 2833357088
FaxNumber: 8284841025
Practice Location
Address1: 204 CHARLOTTE HWY STE E
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288038681
CountryCode: US
TelephoneNumber: 8283335708
FaxNumber: 8284841025
Other Information
ProviderEnumerationDate: 02/19/2013
LastUpdateDate: 06/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X16603NCY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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