Provider Demographics
NPI:1255354445
Name:LYON, JOANNE B (PHD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:B
Last Name:LYON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8340 MISSION RD
Mailing Address - Street 2:STE 225
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66206
Mailing Address - Country:US
Mailing Address - Phone:913-381-1690
Mailing Address - Fax:913-381-8060
Practice Address - Street 1:8340 MISSION RD
Practice Address - Street 2:STE 225
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206
Practice Address - Country:US
Practice Address - Phone:913-381-1690
Practice Address - Fax:913-381-8060
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0691103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
27644018OtherBCBS OF KANSAS CITY
KS010601Medicare ID - Type Unspecified