Healthcare Provider Details

I. General information

NPI: 1861317489
Provider Name (Legal Business Name): MR. TYLER WOOLINGTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 SW AUBURN RD
TOPEKA KS
66614-4843
US

IV. Provider business mailing address

2315 SW ROMAR RD
TOPEKA KS
66614-6066
US

V. Phone/Fax

Practice location:
  • Phone: 785-408-8409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number14384
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: