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General NPI Number Information
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NPI Number | 1902775513
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Entity Type | Organization
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Legal Business Name | TYLER BRESHEARS LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1321 BURLINGTON ST STE 200
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-4007
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Country | US
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Telephone | 816-514-1004
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Fax |
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Provider Business Mailing Address
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Address Line | 3611 NE 42ND TER
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City | KANSAS CITY
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State | MO
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Zip | 64117-1718
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Country | US
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Telephone | 816-868-2430
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Fax |
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Authorized Official
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Title or Position | OWNER AND SOLE-PROVIDER
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Name | TYLER BRESHEARS
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Credential | LPC
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Telephone | 816-514-1004
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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 |
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License Number State |
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