MEDICARE: TYLER WHITE LPCC

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
1	101YP2500X	Professional Counselor	LPCC.0020038	CO

General Provider Information

NPI Number	:	1407555089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER WHITE LPCC

Provider Business Mailing Address
First Line	:	870 S COLORADO BLVD # 1172
Second Line	:
City	:	GLENDALE
State	:	CO
Zip	:	80246-2080
Country	:	US
Telephone Number	:	720-441-3201
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 S PIERCE ST STE 235
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-7206
Country	:	US
Telephone Number	:	720-441-3201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	03/02/2023

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Directions to “ TYLER WHITE LPCC” Practice Location

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