MEDICARE: TYLER FARRELL, LLC

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1760317473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TYLER FARRELL, LLC

Provider Business Mailing Address
First Line	:	1611 CARRIAGE HOUSE TER APT D
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2285
Country	:	US
Telephone Number	:	817-269-1310
Fax Number	:	817-269-1310

Provider Business Practice Location Address
First Line	:	1611 CARRIAGE HOUSE TER APT D
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2285
Country	:	US
Telephone Number	:	817-269-1310
Fax Number	:	817-269-1310

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. TYLER FARRELL
Credential	:	PH.D.
Telephone Number	:	817-269-1310

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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