Amanda Lytle, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

023402 Issued in NY

Practice address

1025 Northern Blvd Ste 304
Roslyn, NY 11576-1506

Phone

(516) 331-1560

NPI assigned

Oct 18, 2019

Last updated

Oct 18, 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

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.

Opted out of Medicare

Yes, effective Apr 27, 2021 through Apr 27, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1649813023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MILLFORD DR",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 NORTHERN BLVD STE 304",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761506",
            "telephone_number": "516-331-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTLE",
        "first_name": "AMANDA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Long Island DBT Group
• Long Island Jewish Faculty Medical Affiliates, University Faculty Prac
• Tanya Claire Louis
• Lillian Yinqi Lu
• Douglas Michael Luxenberg, D.O.
• Antonio P Madrid, MD
• Farinaz Golda Mairzadeh, D.D.S
• Valerie L Makarick, MD
• Gabriella Carolann Malatino
• Michael Malavet, P.A.

• Psychologist in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.