Provider Demographics
NPI:1447076120
Name:LYONS, CANDY LYNN (LISW)
Entity type:Individual
Prefix:MISS
First Name:CANDY
Middle Name:LYNN
Last Name:LYONS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:CANDY
Other - Middle Name:LYNN
Other - Last Name:LYONS-TOWNSEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2913 SOUTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-5719
Mailing Address - Country:US
Mailing Address - Phone:937-689-1663
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS PLZ
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1815
Practice Address - Country:US
Practice Address - Phone:937-641-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23049961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical