Provider Demographics
NPI:1922027432
Name:LYTLE, DANIEL RICHARD (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICHARD
Last Name:LYTLE
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:RICHARD
Other - Last Name:LYTLE
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:500 W WILSON BRIDGE RD
Mailing Address - Street 2:240
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2238
Mailing Address - Country:US
Mailing Address - Phone:614-847-8242
Mailing Address - Fax:614-847-9322
Practice Address - Street 1:500 W WILSON BRIDGE RD
Practice Address - Street 2:240
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2238
Practice Address - Country:US
Practice Address - Phone:614-847-8242
Practice Address - Fax:614-847-9322
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 0001276101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health