Active NPI
Tye Walcott, LPC
- Professional Counselor
- Savannah, GA
National Provider Identifier
1003109984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC006467
- Practice address
- 125 Fahm St
Savannah, GA 31401-2391 - Phone
- (912) 344-9403
- NPI assigned
- May 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC006467 | GA | Primary |
Addresses
Primary practice location
125 Fahm St
Savannah, GA 31401-2391
Mailing address
3441 Cypress Mill Rd
Suite 102
Brunswick, GA 31520-2878
Phone (912) 264-0979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC006467 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1003109984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3441 CYPRESS MILL RD",
"address_2": "SUITE 102",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315202878",
"telephone_number": "912-264-0979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 FAHM ST",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314012391",
"telephone_number": "912-344-9403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALCOTT",
"first_name": "TYE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-25",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC006467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.