Individual
CHARLTON LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
890 NORTHWOODS PLAZA, MACON, GA 31204
(478) 330-7164
Mailing address
890 NORTHWOODS PLAZA, MACON, GA 31204
(478) 330-7164
(478) 330-7167
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056939681
DRIVER'S LICENSE
GA
Enumeration date
01/05/2021
Last updated
01/05/2021
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