Active NPI
Carroll Yvette Lytch, PSY.D.
- Clinical Psychologist
- Charlotte, NC
National Provider Identifier
1639294747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2604
- Practice address
- 5354 Glenlea Walk LN
Charlotte, NC 28216-9531 - Phone
- (704) 393-5826
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2604 | NC | Primary |
| Clinical Psychologist | 103TC0700X | 768 | SC |
Addresses
Primary practice location
5354 Glenlea Walk LN
Charlotte, NC 28216-9531
Mailing address
5354 Glenlea Walk LN
Charlotte, NC 28216-9531
Phone (704) 393-5826
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2604 | NC | MD | Psychologist |
| 768 | SC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1639294747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5354 GLENLEA WALK LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282169531",
"telephone_number": "704-393-5826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5354 GLENLEA WALK LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282169531",
"telephone_number": "704-393-5826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYTCH",
"first_name": "CARROLL",
"middle_name": "YVETTE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2604",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "768",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.