Provider Demographics
NPI:1598580110
Name:LYON, JONATHAN (MA, LBS, BCBA)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:LYON
Suffix:
Gender:M
Credentials:MA, LBS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SOUTHWATCH LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-8213
Mailing Address - Country:US
Mailing Address - Phone:717-614-3506
Mailing Address - Fax:
Practice Address - Street 1:7540 ALLENTOWN BLVD STE 5
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-4238
Practice Address - Country:US
Practice Address - Phone:223-797-1485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-24-77346103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst