Individual provider Active NPI

Cassandra Lynn Lyles, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Madison, WI
National Provider Identifier
1972324259
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
15716 Issued in WI
Practice address
122 W Washington Ave Ste 630
Madison, WI 53703-2758
Phone
(262) 999-3495
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15716 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 15716 WI Primary

Addresses

Primary practice location

122 W Washington Ave Ste 630
Madison, WI 53703-2758

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (262) 999-3495

Other practice location 1

1333 College Ave
South Milwaukee, WI 53172-1150
Phone (414) 380-3231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028002046 WI Practitioner - Nurse Practitioner 4183113400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

122 W Washington Ave
Suite 630
Madison, WI 53703-2758
Phone (608) 236-4460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15716WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Nov 3, 2025 Accepting new patients
Premier Care of Wisconsin, LLC. Past Accepting new patients
Premier Care of Wisconsin, LLC. Past Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

122 W Washington Ave
Ste 630
Madison, WI 53703
Phone (608) 424-8411

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.cassandralyles@149809.advancedmd-direct.com

Organizations & group practices 3

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": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1972324259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "262-999-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W WASHINGTON AVE STE 630",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032758",
            "telephone_number": "262-999-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 College Ave",
            "address_purpose": "LOCATION",
            "city": "South Milwaukee",
            "state": "WI",
            "postal_code": "531721150",
            "country_code": "US",
            "telephone_number": "414-380-3231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYLES",
        "first_name": "CASSANDRA",
        "middle_name": "LYNN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "15716",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "15716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.