MEDICARE: KAREN A. LYTTLE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	ISW13869	FL
2	1041C0700X	Clinical Social Worker	ISW13869	FL

General Provider Information

NPI Number	:	1528691177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN A. LYTTLE LCSW

Provider Business Mailing Address
First Line	:	2717 W CYPRESS CREEK RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1756
Country	:	US
Telephone Number	:	954-683-3902
Fax Number	:

Provider Business Practice Location Address
First Line	:	2717 W CYPRESS CREEK RD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-1756
Country	:	US
Telephone Number	:	954-979-7911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2020
Last Update Date	:	02/29/2024

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