Active NPI
Vivian Tyler, AMFT
- Mental Health Counselor
- Chester, PA
National Provider Identifier
1033776679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 301 W 15TH St
Chester, PA 19013-5300 - Phone
- (610) 619-8741
- NPI assigned
- May 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PA | Primary |
Addresses
Primary practice location
301 W 15TH St
Chester, PA 19013-5300
Mailing address
555 Second Ave BLDG B3
Collegeville, PA 19426-3600
Phone (267) 388-0381
Other practice location 1
2000 Old West Chester Pike
Havertown, PA 19083-2712
Phone (484) 454-8700 ext. 1166
Other practice location 2
555 Second Ave Bldg B3
Collegeville, PA 19426-3600
Phone (484) 938-8461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YM0800X | Medicaid | PA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1033776679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 SECOND AVE BLDG B3",
"city": "COLLEGEVILLE",
"state": "PA",
"postal_code": "194263600",
"telephone_number": "267-388-0381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W 15TH ST",
"city": "CHESTER",
"state": "PA",
"postal_code": "190135300",
"telephone_number": "610-619-8741"
}
],
"practiceLocations": [
{
"address_1": "2000 Old West Chester Pike",
"address_purpose": "LOCATION",
"city": "Havertown",
"state": "PA",
"postal_code": "190832712",
"country_code": "US",
"telephone_number": "484-454-8700 x1166",
"fax_number": "610-449-2192",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "555 Second Ave Bldg B3",
"address_purpose": "LOCATION",
"city": "Collegeville",
"state": "PA",
"postal_code": "194263600",
"country_code": "US",
"telephone_number": "484-938-8461",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TYLER",
"first_name": "VIVIAN",
"credential": "AMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-20",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101YM0800X",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.