1922027432 NPI number — DANIEL RICHARD LYTLE M.S.W., L.I.S.W.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922027432 NPI number — DANIEL RICHARD LYTLE M.S.W., L.I.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYTLE
Provider First Name:
DANIEL
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., L.I.S.W.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LYTLE
Provider Other First Name:
DANIEL
Provider Other Middle Name:
RICHARD
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
III
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1922027432
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 W WILSON BRIDGE RD
Provider Second Line Business Mailing Address:
240
Provider Business Mailing Address City Name:
WORTHINGTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43085-2238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-847-8242
Provider Business Mailing Address Fax Number:
614-847-9322

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 W WILSON BRIDGE RD
Provider Second Line Business Practice Location Address:
240
Provider Business Practice Location Address City Name:
WORTHINGTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43085-2238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-847-8242
Provider Business Practice Location Address Fax Number:
614-847-9322
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  I 0001276 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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