Individual provider · Type 1 NPI

Mancell Vontrell Lyttle, CDCA

Addiction (Substance Use Disorder) Counselor · Wilmington, OH

NPI number 1104416841 Active

Practice location

815 S South St
Wilmington, OH 45177-2755

Fax (800) 480-7578

Mailing address

4120 Brookdale Ln Unit 5
Dayton, OH 45440-3998

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCDCA.193768 (OH)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104416841

Mancell Vontrell Lyttle, CDCA's National Provider Identifier is 1104416841, issued on Jan 26, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Wilmington, OH. The record was last updated on Sep 29, 2025.