Individual
SANDRA STACEY JESSUP LYONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Contact information
Practice address
1700 W KOCH ST STE 9, BOZEMAN, MT 59715-4148
(406) 600-3247
Mailing address
147 TALON WAY UNIT A, BOZEMAN, MT 59718-9626
(406) 600-3247
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
57706
MT
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-57706
MT
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-88081
MT
Other
Enumeration date
06/26/2023
Last updated
03/10/2026
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