Provider Demographics
NPI:1174107486
Name:LYON, BETHANY LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:LYON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:LYNN
Other - Last Name:BRODIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:321 REPP RD
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-9337
Mailing Address - Country:US
Mailing Address - Phone:412-576-9105
Mailing Address - Fax:
Practice Address - Street 1:5375 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9666
Practice Address - Country:US
Practice Address - Phone:724-444-2018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0196041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical