Individual
MR. EDWARD STEPHEN LYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCS, CSAC, CCJP
Contact information
Practice address
4315 LUDGATE STREET, LUMBERTON, NC 28358-2460
(910) 301-9273
(910) 738-1991
Mailing address
725 BYRD ROAD, SELMA, NC 27576-9077
(910) 301-9273
(910) 738-1991
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
263
NC
103K00000X
Behavior Analyst
#1429
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6110514
—
NC
01
—
CCS # 263
NCSAPPB NORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD
NC
01
—
CSAC #1429
NORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD
NC
Enumeration date
05/01/2007
Last updated
12/22/2011
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