Individual provider Active NPI

Patricia M Lyles

  • Addiction (Substance Use Disorder) Counselor
  • Hamilton, OH
National Provider Identifier
1215446620
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
161796 Issued in OH
Practice address
515 Dayton St
Hamilton, OH 45011-3455
Phone
(513) 868-7654
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCIII.14173 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 161796 OH Primary

Addresses

Primary practice location

515 Dayton St
Hamilton, OH 45011-3455

Mailing address

515 Dayton St
Hamilton, OH 45011-3455
Phone (513) 868-7654

Other identifiers 1

IdentifierTypeStateIssuer
0283320MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
161796OHMDAddiction (Substance Use Disorder) Counselor
LCDCIII.14173OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215446620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DAYTON ST",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450113455",
            "telephone_number": "513-868-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DAYTON ST",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450113455",
            "telephone_number": "513-868-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLES",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.14173",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "161796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0283320",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.