Lillie Vanessa Lyons, LGSW

Individual provider Active NPI Social Worker · Washington, DC

NPI 1306207741 · NPPES record last updated Mar 13, 2016

Key facts

NPI
1306207741
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
LG100834 (DC)
Practice address
2616 Martin Luther King Jr Ave SE
Washington, DC 20020-7715
Phone
(202) 724-7847
Fax
(202) 724-7846
NPI assigned
Mar 13, 2016
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LG100834DCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Paving the Way Multi Service Institute Past
since Nov 27, 2016
Accepting new patients
Zion Family Practice, LLC Past
since May 20, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LG100834 DC Yes
Social Worker 104100000X MD

Addresses

Primary practice location

2616 Martin Luther King Jr Ave SE
Washington, DC 20020-7715

Mailing address

716 Gallatin St NW
Washington, DC 20011-4028
Phone (202) 465-2293

Other providers in Washington, DC

All providers in Washington, DC · Social Worker in District of Columbia

Sources for this page

Verify at the official NPI Registry.