Angela Lyon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1772 Issued in NE

Practice address

223 N Locust St Apt 1
Grand Island, NE 68801-5930

Phone

(308) 391-2280

NPI assigned

Aug 6, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revive Behavioral Health and Wellness LLC

  • Clinical Social Worker
  • Grand Island, NE
  • NPI 1548926801
  Medicare reassignment NPD Authorized official
• McDowell Counseling & Associates, LLC

  • Mental Health Counselor
  • Kearney, NE
  • NPI 1598461121
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1063844645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N LOCUST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015920",
            "telephone_number": "308-392-2280",
            "fax_number": "308-832-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N LOCUST ST APT 1",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015930",
            "telephone_number": "308-391-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1700",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Kay Lutt
• Dawn Lutz, LPN
• Derek C Lux, DC
• Luxottica of America Inc. (Lenscrafters #389)
• Lynn E Flint Widdifield
• M H Solutions Inc
• Sarah Maaske, OTR/L
• Angela M Maciejewski
• Andrea Mack, OT
• Sarah Maddox-Clark

• Clinical Social Worker in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Clinical Social Worker in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.