Provider Demographics
NPI:1861131252
Name:LYLE, CRYSTAL D (LPC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:D
Last Name:LYLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72616-3931
Mailing Address - Country:US
Mailing Address - Phone:870-955-4054
Mailing Address - Fax:
Practice Address - Street 1:310 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BERRYVILLE
Practice Address - State:AR
Practice Address - Zip Code:72616-3931
Practice Address - Country:US
Practice Address - Phone:870-955-4054
Practice Address - Fax:479-397-3311
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2403013101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health