Healthcare Provider Details

I. General information

NPI: 1154112779
Provider Name (Legal Business Name): MARGARET LYTTLE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET HASWELL

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

1339 WESTMORELAND AVE
SYRACUSE NY
13210-3436
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-5540
  • Fax:
Mailing address:
  • Phone: 315-529-8102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number103411
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: