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NPI Code Detail

MEDICARE: TYLER W SECOR LPC

MEDICARE: TYLER W SECOR LPC
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
1101YP2500XProfessional Counselor8580125WI

General Provider Information

NPI Number : 1740840420
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER W SECOR LPC
Provider Business Mailing Address
First Line : 4006 WASHINGTON RD
Second Line :
City : KENOSHA
State : WI
Zip : 53144-4819
Country : US
Telephone Number : 262-656-0044
Fax Number : 262-649-1977
Provider Business Practice Location Address
First Line : 4006 WASHINGTON RD
Second Line :
City : KENOSHA
State : WI
Zip : 53144-4819
Country : US
Telephone Number : 262-656-0044
Fax Number : 262-649-1977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2019
Last Update Date : 03/03/2026

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Directions to “ TYLER W SECOR LPC” Practice Location

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