Kim Jeannette Lytle, MS LPC CAADC NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401014824 Issued in MI

Practice address

520 N Main St
Suite 202
Cheboygan, MI 49721-1162

Phone

(231) 597-9235

Fax

(231) 627-4201

NPI assigned

May 17, 2016

Last updated

Apr 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1417304791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N MAIN ST",
            "address_2": "SUITE 202",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497211162",
            "telephone_number": "231-597-9235",
            "fax_number": "231-627-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N MAIN ST",
            "address_2": "SUITE 202",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497211162",
            "telephone_number": "231-597-9235",
            "fax_number": "231-627-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTLE",
        "first_name": "KIM",
        "middle_name": "JEANNETTE",
        "credential": "MS LPC CAADC NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401014824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Cheboygan, MI
• Providers in Cheboygan, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.