Individual provider Active NPI

Antoinette Romaine Lyons, LMFT-I

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1205403664
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M14004 Issued in NV
Practice address
3376 S Eastern Ave Ste 148
Las Vegas, NV 89169-3367
Phone
(702) 272-0025
Fax
(702) 920-8226
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF87998 CA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X M14004 NV Primary

Addresses

Primary practice location

3376 S Eastern Ave Ste 148
Las Vegas, NV 89169-3367

Mailing address

204 W Pacific Ave
Henderson, NV 89015-7376
Phone (702) 565-1020

Other practice location 1

129 W Lake Mead Pkwy Ste 8
Henderson, NV 89015-7055
Phone (702) 701-7900

Other practice location 2

204 W Pacific Ave
Henderson, NV 89015-7376
Phone (702) 565-1020

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

State licenses

LicenseStateTypeSpecialty
IMF87998CAMDMarriage & Family Therapist
M14004NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Zane Medical Group LLC Multi-Specialty CurrentSince Jun 22, 2021 Accepting new patients
Urban Healthy Minds, LLC Multi-Specialty Past Accepting new patients

Locations

3376 S Eastern Ave
Ste 148
Las Vegas, NV 89169
Phone (702) 272-0025

Organizations & group practices 2

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1205403664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W PACIFIC AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157376",
            "telephone_number": "702-565-1020",
            "fax_number": "702-565-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3376 S EASTERN AVE STE 148",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693367",
            "telephone_number": "702-272-0025",
            "fax_number": "702-920-8226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 W Lake Mead Pkwy Ste 8",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890157055",
            "country_code": "US",
            "telephone_number": "702-701-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 W Pacific Ave",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890157376",
            "country_code": "US",
            "telephone_number": "702-565-1020",
            "fax_number": "702-565-1035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "ANTOINETTE",
        "middle_name": "ROMAINE",
        "credential": "LMFT-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF87998",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "M14004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.