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General NPI Number Information
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NPI Number | 1821583238
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Entity Type | Individual
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Provider Name | TYLER JAMES LPC, MA
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Gender | Male
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 400 CHISHOLM PL STE 114
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City | PLANO
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State | TX
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Zip | 75075-6957
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Country | US
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Telephone | 302-497-5023
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LEGACY DR APT 2424
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City | PLANO
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State | TX
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Zip | 75023-2329
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Country | US
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Telephone | 972-415-9163
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 75372
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 75372
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License Number State | TX
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