Individual provider Active NPI

Daryl Lytle, LMHC

  • Mental Health Counselor
  • St George, UT
National Provider Identifier
1497108872
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6240769-6004 Issued in UT
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

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240123004915 UT Practitioner - Mental Health Counselor 6406208677 Reassigns benefits to 1 organization
I20251023001321 CA Practitioner - Mental Health Counselor 6406208677 Reassigns benefits to 1 organization

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
Alberto Souza PLLCGroup PAC ID 1254766371, 9 clinicians
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

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

LicenseStateTypeSpecialty
LMHC10003114MAMDMental Health Counselor
37PC00936800NJMDMental Health Counselor
014689NYMDMental Health Counselor
13317CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Addiction (Substance Use Disorder) CurrentSince Oct 7, 2025 Accepting new patients
Alberto Souza, PLLC CurrentSince Jan 1, 2024 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.

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

Verify at the official NPI Registry.