NPIMap

Individual provider Active NPI

Lisa Renee Marr Lyon, PH.D.

  • School Psychologist
  • Los Alamos, NM
National Provider Identifier
1760824890
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
306556 Issued in NM
Practice address
3917 West Road, Suite 128
Children's Clinic, P.a.
Los Alamos, NM 87544
Phone
(505) 662-4234
NPI assigned
Jul 17, 2013
Last updated
Jul 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 306556 NM Primary

Addresses

Primary practice location

3917 West Road, Suite 128
Children's Clinic, P.a.
Los Alamos, NM 87544

Mailing address

3917 West Road, Suite 128
Los Alamos Children's Clinic
Los Alamos, NM 87544
Phone (505) 662-4234

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
306556NMMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Clinic, P.a. Past Accepting new patients

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1760824890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST ROAD, SUITE 128",
            "address_2": "LOS ALAMOS CHILDREN'S CLINIC",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "87544",
            "telephone_number": "505-662-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST ROAD, SUITE 128",
            "address_2": "CHILDREN'S CLINIC, P.A.",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "87544",
            "telephone_number": "505-662-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARR LYON",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NM",
            "license": "306556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.