Provider Demographics
NPI:1316709041
Name:LYONS, THOMAS MATTHEW (LMFT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:MATTHEW
Last Name:LYONS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4705
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-4705
Mailing Address - Country:US
Mailing Address - Phone:323-202-6710
Mailing Address - Fax:
Practice Address - Street 1:2500 E PALM CANYON DR APT 78
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-4880
Practice Address - Country:US
Practice Address - Phone:323-202-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123563106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist