Provider Demographics
NPI:1477272441
Name:LYLE, SAVANNAH NICHOLE (MED, LCMHC-A)
Entity Type:Individual
Prefix:MR
First Name:SAVANNAH
Middle Name:NICHOLE
Last Name:LYLE
Suffix:
Gender:F
Credentials:MED, LCMHC-A
Other - Prefix:MR
Other - First Name:NICH
Other - Middle Name:
Other - Last Name:LYLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, LCMHC-A
Mailing Address - Street 1:1975 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-8113
Mailing Address - Country:US
Mailing Address - Phone:615-708-4538
Mailing Address - Fax:
Practice Address - Street 1:28 SCHENCK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-5088
Practice Address - Country:US
Practice Address - Phone:828-618-4873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health