Provider Demographics
NPI:1104800580
Name:LYTH-FRANTZ, LORI A (PHD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:LYTH-FRANTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3296 CHENEY DR
Mailing Address - Street 2:
Mailing Address - City:BEMUS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:14712-9765
Mailing Address - Country:US
Mailing Address - Phone:716-801-5944
Mailing Address - Fax:
Practice Address - Street 1:3296 CHENEY DR
Practice Address - Street 2:
Practice Address - City:BEMUS POINT
Practice Address - State:NY
Practice Address - Zip Code:14712-9765
Practice Address - Country:US
Practice Address - Phone:716-801-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013911103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026991501OtherUNIVERA HEALTHCARE
NY000590273001OtherWNY BLUECROSS/BLUE SHIELD
NY6190377OtherINDEPENDENT HEALTH