Active NPI
Daryl Lytle, LMHC
- Mental Health Counselor
- St George, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6240769-6004
- Practice address
- 1664 S Dixie Dr Ste E102
St George, UT 84770-7329 - Phone
- (435) 703-9647
- Fax
- (435) 703-6003
- NPI assigned
- Jul 20, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 13317 | CA | |
| Mental Health Counselor | 101YM0800X | 37PC00936800 | NJ | |
| Mental Health Counselor | 101YM0800X | 014689 | NY | |
| Mental Health Counselor | 101YM0800X | LMHC10003114 | MA | |
| Mental Health Counselor | 101YM0800X | 6240769-6004 | UT | Primary |
Addresses
Primary practice location
1664 S Dixie Dr Ste E102
St George, UT 84770-7329
Mailing address
1664 S Dixie Dr Ste E102
St George, UT 84770-7329
Phone (435) 703-9647
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1664 S Dixie Dr
Suite E102
St George, UT 84770-7329
Phone (435) 703-9647
5201 Great America Pkwy
Suite 320
Santa Clara, CA 95054-1140
Phone (323) 968-6182
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMHC10003114 | MA | MD | Mental Health Counselor |
| 37PC00936800 | NJ | MD | Mental Health Counselor |
| 014689 | NY | MD | Mental Health Counselor |
| 13317 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sud Specialty Group - Ca | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Alberto Souza, PLLC | Current | Accepting new patients |
Locations
5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182
520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295
1664 S Dixie Dr
Ste E102
St George, UT 84770
Phone 43570396471
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Saint George, UT
- NPI 1972141588
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- Santa Clara, CA
- NPI 1972138238
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731283200000",
"number": "1497108872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1664 S DIXIE DR STE E102",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847707329",
"telephone_number": "435-703-9647",
"fax_number": "435-703-6003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1664 S DIXIE DR STE E102",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847707329",
"telephone_number": "435-703-9647",
"fax_number": "435-703-6003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYTLE",
"first_name": "DARYL",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-20",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "13317",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "37PC00936800",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "014689",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "LMHC10003114",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "6240769-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.