Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Latasha Nicole Lyons

Individual provider Professional Counselor · NPI 1639790264

Latasha Nicole Lyons is a Mental Health Counselor in Mount Vernon, Illinois. Qualified in 2018, 8 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Licensed in
IL
In the registry since
2020
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1004 Mulligan Dr
Mount Vernon, IL 62864-2099
Phone: (708) 238-1876
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 178.015569 (IL)

Record details

NPI number1639790264
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 5, 2020
Last updated in NPPESMay 5, 2020
Certification dateMay 5, 2020
Mailing address1004 Mulligan Dr, Mount Vernon, IL 62864-2099

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mount Vernon