Active NPI
Mary M Lyles, LCSW, PHD
- Clinical Social Worker
- Katy, TX
National Provider Identifier
1962543801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 51404
- Practice address
- 24044 Cinco Village Center Blvd Ste 100
Katy, TX 77494-8433 - Phone
- (832) 576-2526
- Fax
- (281) 886-0481
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 Social Worker | 1041C0700X | 992345 | CO | |
| Clinical Social Worker | 1041C0700X | 51404 | TX | Primary |
Addresses
Primary practice location
24044 Cinco Village Center Blvd Ste 100
Katy, TX 77494-8433
Mailing address
24044 Cinco Village Center Blvd Ste 100
Katy, TX 77494-8433
Phone (832) 576-2526
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 992345 | CO | MD | Clinical Social Worker |
| 51404 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325116800000",
"number": "1962543801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24044 CINCO VILLAGE CENTER BLVD STE 100",
"city": "KATY",
"state": "TX",
"postal_code": "774948433",
"telephone_number": "832-576-2526",
"fax_number": "281-886-0481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24044 CINCO VILLAGE CENTER BLVD STE 100",
"city": "KATY",
"state": "TX",
"postal_code": "774948433",
"telephone_number": "832-576-2526",
"fax_number": "281-886-0481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYLES",
"first_name": "MARY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "LCSW, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2011-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "992345",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "51404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.