DR. LISA RENEE MARR LYON (NPI# 1760824890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760824890 |
| Entity Type | Individual |
| Full Name | DR. LISA RENEE MARR LYON |
| Credential | PH.D. |
| Practice Address |
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 |
| Practice Telephone | 5056624234 |
| Mailing Telephone | 5056624234 |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
306556 | NM | Behavioral Health & Social Service Providers |
| Street Address |
3917 WEST ROAD, SUITE 128 CHILDREN'S CLINIC, P.A. |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| 1366514861 | Corazon Behavioral Health Services Inc | Clinic/Center | 1362 C Trinity Drive, Los Alamos, NM 87544 | 2006-11-14 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114214558 | Roseli Cavalcante | Psychologist | 382 Garver Ln, Los Alamos, NM 87544-3571 | 2011-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703701 | Cara Jean Burrola | Psychologist | 1111 Capitan St Nw, Los Lunas, NM 87031-6909 | 2020-09-08 |
| 1619528510 | Heather Scott | Psychologist | Highway 64, Old High School Road, Shiprock, NM 87420 | 2019-09-23 |
| 1548826829 | Stephanie Trujillo | Psychologist | 2810 N. Swan St., Silver City, NM 88061 | 2019-05-13 |
| 1003384181 | Patricia Keeler | Psychologist | # 50 County Rd. 13, Cuba, NM 87013 | 2018-11-07 |
| 1427562107 | Tascha Just | Psychologist | 1 Sunlit Dr E, Santa Fe, NM 87508-8993 | 2017-11-16 |
| 1164949780 | Christine S. Park | Psychologist | 6020 Constitution Ave Ne Ste 4, Albuquerque, NM 87110-5931 | 2017-08-24 |
| 1982128641 | Krystal Marie Ruiz | Psychologist | 505 S. Main, Ste. 249, Las Cruces, NM 88001 | 2017-08-03 |
| 1700327384 | Anastacia Sena Jaramillo | Psychologist | 126 Silva Ave., Las Vegas, NM 87701 | 2017-03-15 |
| 1477004281 | Ciarra Marrufo | Psychologist | 1100 W Bullock Ave, Artesia, NM 88210-2342 | 2016-10-17 |
| 1346697026 | Mary E. Sawyers, Ma, Lpcc | Psychologist | 1200 N White Sands Blvd Ste 118, Alamogordo, NM 88310-6774 | 2016-05-23 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.