Jaclyn Anna Lyras

Primary specialty

Social WorkerTaxonomy code 104100000X

License

102909-01 Issued in NY

Practice address

428 E Hudson St
Long Beach, NY 11561-2308

Phone

(631) 740-7179

NPI assigned

Jul 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1750061503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 OAKVIEW TRL",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119612210",
            "telephone_number": "631-740-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 E HUDSON ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612308",
            "telephone_number": "631-740-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYRAS",
        "first_name": "JACLYN",
        "middle_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "102909-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mabeline Lugo-Roman, M.A., CCC-SLP
• Annoula Lukas
• David Roger Lutwin, L.C.S.W., D.S.W.
• Barbara Lynch, LMT
• James P. Lynch, R. PH.
• Dorothy Ellen Lystad
• Michael T Maass, RPH PHARMACIST
• Danielle Macpherson, MA LMSW
• Maura Kathleen Maflin
• Heather Magone

• Social Worker in Long Beach, NY
• Providers in Long Beach, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.