Individual provider Active NPI

Zachary Kirt Lyons

  • Clinical Social Worker
  • Plymouth, MI
National Provider Identifier
1457861650
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
9409 N Haggerty Rd
Plymouth, MI 48170-4696
Phone
(734) 559-3540
NPI assigned
Oct 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9409 N Haggerty Rd
Plymouth, MI 48170-4696

Mailing address

9409 N Haggerty Rd
Plymouth, MI 48170-4696
Phone (734) 559-3540

Other practice location 1

1423 Field St
Detroit, MI 48214-2321
Phone (313) 825-2421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220330002892 MI Practitioner - Clinical Social Worker 5991191900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

32841 Middlebelt Rd
Suite 403
Farmington Hills, MI 48334-1714
Phone (734) 761-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Mel Bornstein Clinic for Psychoanalysis and Psychotherapy CurrentSince Jun 26, 2023 Accepting new patients

Locations

1945 Pauline Blvd
Ste 21C
Ann Arbor, MI 48103
Phone (248) 851-7739

32841 Middlebelt Rd
Ste 403
Farmington Hills, MI 48334
Phone (248) 851-7739

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1457861650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9409 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704696",
            "telephone_number": "734-559-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704696",
            "telephone_number": "734-559-3540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1423 Field St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482142321",
            "country_code": "US",
            "telephone_number": "313-825-2421",
            "fax_number": "313-825-2421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "ZACHARY",
        "middle_name": "KIRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-03",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.