Stephanie Lyle, LICSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60431537 Issued in WA

Practice address

1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509

Phone

(360) 910-3276

NPI assigned

Jan 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Real Life Counseling PLLCGroup PAC ID 6406156231, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Real Life Counseling PLLC

  • Clinical Social Worker
  • Vancouver, WA
  • NPI 1053782078
  Medicare reassignment Care Compare group
• Real Life Community Behavioral Health PLLC

  • Mental Health Counselor
  • Vancouver, WA
  • NPI 1952063265
  NPD

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1407245202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16504 NE 35TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986828661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835509",
            "telephone_number": "360-910-3276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16504 NE 35th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986828661",
            "country_code": "US",
            "telephone_number": "360-910-3276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYLE",
        "first_name": "STEPHANIE",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L15159",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60431537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shellie Marie Lyden, PT
• Jenny Barbo Lydick, RN
• Jacqueline Anna Lydston
• Brynn Taylor Lydum, MS CF-SLP
• Courtney Marie Lyell
• Sarah Lynch Dewitt, LCSW
• Colette Lynch-Sajo
• Aurora Lynch, CG
• Dennis M Lynch, CP, LO
• Fanda J Lynch

• Clinical Social Worker in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.