Montgomery Lyons
Individual provider Active NPI Clinical Psychologist · Princeton, MA
NPI 1124500285 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1124500285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 023685 (NY)
- Practice address
- 162 Mountain Rd
Princeton, MA 01541-1108 - Phone
- (844) 222-6037
- NPI assigned
- Sep 5, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Che Senior Psychological Services, PC
Practice addresses (Care Compare)
300 Cadman PLZ W
Brooklyn, NY 11201-3211
Phone (888) 515-3834
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200402002668 | NY | Practitioner - Clinical Psychologist | 6103255724 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Che Senior Psychological Services, PC | Clinical | Current |
Accepting new patients |
Locations
300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955
250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212
135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 023685 | NY | Yes |
Addresses
Primary practice location
162 Mountain Rd
Princeton, MA 01541-1108
Mailing address
162 Mountain Rd
Princeton, MA 01541-1108
Other providers in Princeton, MA
- Paris Day Henderson
- Kendra Ann Johnson
- Frank Joseph Koch
- Anne McCauley Kulakowski
- Dana Lorway
- Maureen A Malin
- Beth Martin
- Rebecca Mathews
- Michael S Morgan Jr.
- Mountain Speak Speech Therapy, L.L.C.
All providers in Princeton, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.