Provider Demographics
NPI:1285999268
Name:LYONS, BRIGID VILARDO (PHD)
Entity type:Individual
Prefix:
First Name:BRIGID
Middle Name:VILARDO
Last Name:LYONS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N FRENCH RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2008
Mailing Address - Country:US
Mailing Address - Phone:716-799-8526
Mailing Address - Fax:
Practice Address - Street 1:415 N FRENCH RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2008
Practice Address - Country:US
Practice Address - Phone:716-799-8526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9704101YM0800X
NYP91196174400000X
NY020747103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025287200Medicaid