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General NPI Number Information
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NPI Number | 1427105261
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Entity Type | Organization
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Legal Business Name | LYLE PROFESSIONAL CONSULTING, LLC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 611 MOOREFIELD PARK DR SUITE C
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3667
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Country | US
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Telephone | 804-745-2660
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Fax | 804-745-2644
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Provider Business Mailing Address
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Address Line | 611 MOOREFIELD PARK DR STE C
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3667
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Country | US
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Telephone | 804-745-2660
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Fax | 804-745-2644
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Authorized Official
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Title or Position | CEO AND PROGRAM DIRECTOR
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Name | MRS. SHEENA ALTHEA LYLE
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Credential | L.C.S.W.
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Telephone | 804-745-2660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 787
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License Number State | VA
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