Mancell Vontrell Lyttle, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.193768 Issued in OH

Practice address

815 S South St
Wilmington, OH 45177-2755

Phone

(937) 910-6218

Fax

(800) 480-7578

NPI assigned

Jan 26, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1104416841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 BROOKDALE LN UNIT 5",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403998",
            "telephone_number": "313-687-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S SOUTH ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772755",
            "telephone_number": "937-910-6218",
            "fax_number": "800-480-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTTLE",
        "first_name": "MANCELL",
        "middle_name": "VONTRELL",
        "name_prefix": "Mr.",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-26",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.193768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Christine Lovano, MD
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• Suzanne I Lukacs
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• William Glenn Macdonald, O.D.
• Carissa C Macella, LPCC
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• Brooke N Malicote, LPN-MEDS-IV
• Olivia Danielle Mandich, PSYD

• Addiction (Substance Use Disorder) Counselor in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.