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NPI Code Detail

MEDICARE: TYKEILA IESHIA TISDALE CMHC, RMHC-I

MEDICARE: TYKEILA IESHIA TISDALE CMHC, RMHC-I
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578326187
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYKEILA IESHIA TISDALE CMHC, RMHC-I
Provider Business Mailing Address
First Line : 9980 HOUND CHASE DR
Second Line :
City : GIBSONTON
State : FL
Zip : 33534-5422
Country : US
Telephone Number : 813-399-4833
Fax Number :
Provider Business Practice Location Address
First Line : 1413 TECH BLVD STE 125
Second Line :
City : TAMPA
State : FL
Zip : 33619-7822
Country : US
Telephone Number : 813-421-3884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2024
Last Update Date : 05/26/2026

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Directions to “ TYKEILA IESHIA TISDALE CMHC, RMHC-I” Practice Location

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