Provider Demographics
NPI:1902817125
Name:ROBERT P. LYLE, JR. LICSW & ASSOCIATES, INC., PS
Entity Type:Organization
Organization Name:ROBERT P. LYLE, JR. LICSW & ASSOCIATES, INC., PS
Other - Org Name:LYLE & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PATTERSON
Authorized Official - Last Name:LYLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LICSW, CEAP, MAC
Authorized Official - Phone:206-527-4395
Mailing Address - Street 1:3924 204TH ST SW
Mailing Address - Street 2:STE. 111
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-9368
Mailing Address - Country:US
Mailing Address - Phone:206-522-5378
Mailing Address - Fax:206-527-3375
Practice Address - Street 1:3924 204TH ST SW
Practice Address - Street 2:STE. 111
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-9368
Practice Address - Country:US
Practice Address - Phone:206-522-5378
Practice Address - Fax:206-527-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000053751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty