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NPI Code Detail

MEDICARE: TYREE TAYLOR

MEDICARE: TYREE TAYLOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1154270833
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYREE TAYLOR
Provider Business Mailing Address
First Line : 2920 W BROAD ST STE 215
Second Line :
City : RICHMOND
State : VA
Zip : 23230-5103
Country : US
Telephone Number : 800-883-8441
Fax Number :
Provider Business Practice Location Address
First Line : 2920 W BROAD ST STE 215
Second Line :
City : RICHMOND
State : VA
Zip : 23230-5103
Country : US
Telephone Number : 800-883-8441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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