Individual provider Active NPI

Jarrett Lyons, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1396552410
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
122734 Issued in NY
Practice address
169 W 133Rd St, New York, Ny 10030
New York, NY 10030-3301
Phone
(646) 762-4950
NPI assigned
Dec 12, 2024
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 122734 NY Primary
Mental Health Counselor 101YM0800X 122734 NY

Addresses

Primary practice location

169 W 133Rd St, New York, Ny 10030
New York, NY 10030-3301

Mailing address

3443 Crescent St Apt 3E
Astoria, NY 11106-3962
Phone (646) 932-4925

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
122734NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Room AIDS Ministry, Inc. Adult Day Health Care Center. Social Worker CurrentSince Dec 15, 2024 Accepting new patients
Shlomit Levy PastSince Dec 15, 2024 Accepting new patients

Locations

169 W 133rd St
New York, NY 10030
Phone (646) 762-4950

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, 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": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1396552410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 CRESCENT ST APT 3E",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111063962",
            "telephone_number": "646-932-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 W 133RD ST, NEW YORK, NY 10030",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100303301",
            "telephone_number": "646-762-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "JARRETT",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "122734",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "122734",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.