Individual provider Active NPI

Jennifer D Lyon, LCSW

  • Clinical Social Worker
  • Crescent Springs, KY
National Provider Identifier
1336851807
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
255429 Issued in KY
Practice address
2034 Lakelyn CT
Crescent Springs, KY 41017-4435
Phone
(859) 240-5967
NPI assigned
Dec 15, 2022
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 255429 KY Primary

Addresses

Primary practice location

2034 Lakelyn CT
Crescent Springs, KY 41017-4435

Mailing address

2034 Lakelyn CT
Crescent Springs, KY 41017-4435
Phone (859) 240-5967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718002612 KY Practitioner - Clinical Social Worker 9830559103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
May accept Medicare assignment
Group practices
Little Psychological Services, PLLCGroup PAC ID 6901892413, 3 clinicians

Practice addresses (Care Compare)

6900 Houston Rd
Suite 11
Florence, KY 41042-4891
Phone (859) 525-4911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
255429KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Little Psychological Services, PLLC CurrentSince Jun 13, 2023 Accepting new patients

Locations

162 Barnwood Dr
Edgewood, KY 41017
Phone (859) 331-4159

6900 Houston Rd
Bldg 500
Florence, KY 41042
Phone (859) 525-2020

6900 Houston Rd
Ste 11
Florence, KY 41042
Phone (859) 525-4911

211 Grandview Dr
#106
Ft Mitchell, KY 41017
Phone (859) 344-6409

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1336851807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 LAKELYN CT",
            "city": "CRESCENT SPRINGS",
            "state": "KY",
            "postal_code": "410174435",
            "telephone_number": "859-240-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 LAKELYN CT",
            "city": "CRESCENT SPRINGS",
            "state": "KY",
            "postal_code": "410174435",
            "telephone_number": "859-240-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent Springs, KY

Sources for this page

Verify at the official NPI Registry.