Provider Demographics
NPI:1285953273
Name:LYTLE, JEAN NELSON (LPC-MHSP)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:NELSON
Last Name:LYTLE
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 BELCOR DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-8645
Mailing Address - Country:US
Mailing Address - Phone:615-767-2292
Mailing Address - Fax:
Practice Address - Street 1:367 RIVERSIDE DR
Practice Address - Street 2:SUITE 118
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-8984
Practice Address - Country:US
Practice Address - Phone:615-767-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-31
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional