Healthcare Provider Details

I. General information

NPI: 1306740592
Provider Name (Legal Business Name): TYLER SLAY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHPOINTE CT STE D
BRANDON MS
39042-7016
US

IV. Provider business mailing address

100 HIGHPOINTE CT STE D
BRANDON MS
39042-7016
US

V. Phone/Fax

Practice location:
  • Phone: 601-790-0250
  • Fax:
Mailing address:
  • Phone: 601-790-0250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: TYLER SLAY
Title or Position: OWNER
Credential: LPC
Phone: 601-790-0250