Individual provider Active NPI

Erin Dawn Lyon, LMSW, MA

  • Social Worker
  • Penfield, NY
National Provider Identifier
1083338073
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
111492-01 Issued in NY
Practice address
21 Willow Pond Way Ste 103
Penfield, NY 14526-2687
Phone
(585) 385-6030
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 111492-01 NY Primary

Addresses

Primary practice location

21 Willow Pond Way Ste 103
Penfield, NY 14526-2687

Mailing address

29 South Ave
Brockport, NY 14420-2007
Phone (585) 286-7559

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
111492-01NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Counseling Associates Inc PastSince Oct 9, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1083338073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SOUTH AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144202007",
            "telephone_number": "585-286-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY STE 103",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262687",
            "telephone_number": "585-385-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "ERIN",
        "middle_name": "DAWN",
        "credential": "LMSW, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "111492-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.