Provider Demographics
NPI:1366064933
Name:LYONS, RACHAEL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:
Last Name:LYONS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:BOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, CSW
Mailing Address - Street 1:701 CLEAR SPRING CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4203
Mailing Address - Country:US
Mailing Address - Phone:502-523-3917
Mailing Address - Fax:
Practice Address - Street 1:321 W STEPHEN FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1419
Practice Address - Country:US
Practice Address - Phone:502-233-2198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-17
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2541061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical