Provider Demographics
NPI:1962812966
Name:LYONS GROUP NASHVILLE LLP
Entity type:Organization
Organization Name:LYONS GROUP NASHVILLE LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASMYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:615-523-9933
Mailing Address - Street 1:1231 9TH AVE N
Mailing Address - Street 2:TRANSFORMATION SERVICES
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2552
Mailing Address - Country:US
Mailing Address - Phone:615-523-9933
Mailing Address - Fax:615-928-7050
Practice Address - Street 1:1231 9TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2552
Practice Address - Country:US
Practice Address - Phone:615-523-9933
Practice Address - Fax:615-928-7050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN170678251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10350I5305OtherMEDICARE PTAN
TN10370G3969OtherMEDICARE PTNN