Individual provider Active NPI

Patricia T Lyons, PHD

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1124063276
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011984 Issued in NY
Practice address
5110 12TH Ave
Brooklyn, NY 11219-3424
Phone
(800) 275-3243
Fax
(800) 275-3671
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 011984 NY Primary

Addresses

Primary practice location

5110 12TH Ave
Brooklyn, NY 11219-3424

Mailing address

P.O. Box 32397
Jamaica, NY 11431
Phone (718) 291-0205

Other identifiers 1

IdentifierTypeStateIssuer
01470653MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
MN Psychological Services PLLC CurrentSince Jul 21, 2019 Accepting new patients

Locations

5705 Foster Ave
Brooklyn, NY 11234
Phone (646) 457-4800

820 Front St
Hempstead, NY 11550
Phone (516) 564-1100

9502 Rockaway Beach Blvd
Rockaway Beach, NY 11693
Phone (718) 474-2478

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1124063276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 32397",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11431",
            "telephone_number": "718-291-0205",
            "fax_number": "718-291-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 12TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193424",
            "telephone_number": "800-275-3243",
            "fax_number": "800-275-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "PATRICIA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01470653",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.