Individual
NICOLE LYONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6502 GRAND TETON PLZ STE 102, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Mailing address
6502 GRAND TETON PLZ STE 102, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9155-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130635
DSPS
WI
Enumeration date
01/29/2018
Last updated
05/10/2021
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