Individual provider Active NPI

Crystal D Lyle, LPC

  • Professional Counselor
  • Berryville, AR
National Provider Identifier
1861131252
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P2403013 Issued in AR
Practice address
310 S Main St Ste B
Berryville, AR 72616-3931
Phone
(870) 955-4054
Fax
(479) 397-3311
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P2403013 AR
Professional Counselor 101YP2500X P2403013 AR Primary

Addresses

Primary practice location

310 S Main St Ste B
Berryville, AR 72616-3931

Mailing address

310 S Main St Ste B
Berryville, AR 72616-3931
Phone (870) 955-4054

Other practice location 1

107 E Crandall Ave
Harrison, AR 72601-3629
Phone (870) 204-7488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240422001370 AR Practitioner - Mental Health Counselor 6305285412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1861131252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S MAIN ST STE B",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726163931",
            "telephone_number": "870-955-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S MAIN ST STE B",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726163931",
            "telephone_number": "870-955-4054",
            "fax_number": "479-397-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 E Crandall Ave",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "AR",
            "postal_code": "726013629",
            "country_code": "US",
            "telephone_number": "870-204-7488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYLE",
        "first_name": "CRYSTAL",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2403013",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2403013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

Verify at the official NPI Registry.