Individual
JUSTIN HARRISON LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-II, QMHA-I, CRM
Contact information
Practice address
320 SW RAMSEY AVE, GRANTS PASS, OR 97527-5529
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
101YM0800X
Mental Health Counselor
—
OR
175T00000X
Peer Specialist
25-CRM-4079
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500835861
—
OR
05
—
500835867
—
OR
Enumeration date
07/27/2023
Last updated
03/17/2026
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