Active NPI
Ian C Lyons, LMSW
- Social Worker
- Farmingville, NY
National Provider Identifier
1053410647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 071541
- Practice address
- 15 Horseblock PL
Farmingville, NY 11738-1204 - Phone
- (631) 854-2552
- Fax
- (631) 854-2550
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 071541 | NY | Primary |
Addresses
Primary practice location
15 Horseblock PL
Farmingville, NY 11738-1204
Mailing address
85 Mulberry CMNS
Riverhead, NY 11901-2658
Phone (516) 592-0831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071541 | Other | NY | NEW YORK STATE LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071541 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053410647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 MULBERRY CMNS",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012658",
"telephone_number": "516-592-0831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 HORSEBLOCK PL",
"city": "FARMINGVILLE",
"state": "NY",
"postal_code": "117381204",
"telephone_number": "631-854-2552",
"fax_number": "631-854-2550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "IAN",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "071541",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE LICENSE #",
"identifier": "071541",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Farmingville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.