MEDICARE: MYTA PSYCHOLOGICAL SERVICES, PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1134076078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYTA PSYCHOLOGICAL SERVICES, PLLC

Provider Business Mailing Address
First Line	:	11 JEAN ST
Second Line	:
City	:	RYE
State	:	NY
Zip	:	10580-3225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 JEAN ST
Second Line	:
City	:	RYE
State	:	NY
Zip	:	10580-3225
Country	:	US
Telephone Number	:	914-236-0155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEXA MYTA
Credential	:	PSYD
Telephone Number	:	914-236-0155

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/18/2026

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