Provider Demographics
NPI:1447288931
Name:LYON, PENELOPE FIELD (MSW)
Entity type:Individual
Prefix:MRS
First Name:PENELOPE
Middle Name:FIELD
Last Name:LYON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 ALMAR DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4870
Mailing Address - Country:US
Mailing Address - Phone:412-367-1315
Mailing Address - Fax:
Practice Address - Street 1:345 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2208
Practice Address - Country:US
Practice Address - Phone:412-741-7430
Practice Address - Fax:412-741-5171
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW003621E101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health