Healthcare Provider Details

I. General information

NPI: 1760317473
Provider Name (Legal Business Name): TYLER FARRELL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 CARRIAGE HOUSE TER APT D
SILVER SPRING MD
20904-2285
US

IV. Provider business mailing address

1611 CARRIAGE HOUSE TER APT D
SILVER SPRING MD
20904-2285
US

V. Phone/Fax

Practice location:
  • Phone: 817-269-1310
  • Fax: 817-269-1310
Mailing address:
  • Phone: 817-269-1310
  • Fax: 817-269-1310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. TYLER FARRELL
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 817-269-1310