| Lyons Clinical Counseling & Associates, P.c. | |
|
1065 Martin Luther King Dr Centralia IL 62801-3001 | |
| (618) 545-0770 | |
| (618) 545-0754 |
| Full Name | Lyons Clinical Counseling & Associates, P.c. |
|---|---|
| Speciality | Counselor |
| Location | 1065 Martin Luther King Dr, Centralia, Illinois |
| Authorized Official Name and Position | Roger K. Lyons (PRESIDENT/THERAPIST) |
| Authorized Official Contact | 6182521722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lyons Clinical Counseling & Associates, P.c. 2125 Hortense St P.o. Box 393 Murphysboro IL 62966-1749 Ph: (618) 684-6000 | Lyons Clinical Counseling & Associates, P.c. 1065 Martin Luther King Dr Centralia IL 62801-3001 Ph: (618) 545-0770 |
| NPI Number | 1841482379 |
|---|---|
| Provider Enumeration Date | 08/17/2007 |
| Last Update Date | 08/17/2007 |
| Medicare PECOS PAC ID | 2264572742 |
|---|---|
| Medicare Enrollment ID | O20091214000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841482379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Illinois) | Primary |
| Provider Name | Ronald D Lyons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548453384 PECOS PAC ID: 3870633357 Enrollment ID: I20091214000466 |
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