Healthcare Provider Details

I. General information

NPI: 1255836169
Provider Name (Legal Business Name): TYLER ALEXIUS LANGE LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 ROOKIN ST STE 200
HOUSTON TX
77074-5019
US

IV. Provider business mailing address

100 W TEXAS AVE APT 613
WEBSTER TX
77598-3263
US

V. Phone/Fax

Practice location:
  • Phone: 713-351-7350
  • Fax:
Mailing address:
  • Phone: 985-285-6096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number88494
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: