Alicia Harris Tyler

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P120551 Issued in NY

Practice address

106 S Perry St
Watkins Glen, NY 14891-1636

Phone

(607) 535-8282

Fax

(607) 535-8284

NPI assigned

Mar 23, 2023

Last updated

Mar 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ejc Mental Health Counseling PLLC

  dba Creative Resilience Mental Health Counseling

  • Mental Health Counselor
  • New York, NY
  • NPI 1346088234
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1033812524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S PERRY ST",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911636",
            "telephone_number": "607-535-8282",
            "fax_number": "607-535-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S PERRY ST",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911636",
            "telephone_number": "607-535-8282",
            "fax_number": "607-535-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "ALICIA",
        "middle_name": "HARRIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P120551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nita Toupin, PMHNP
• Angaleen Louise Trentanelli, LMHC
• Kathryn Elizabeth Tunison, LCSW-R
• Nicole C Turnmyre, RPN
• Twin Tiers Eye Care Associates, PC
• Seragina Valenza, LMSW
• Logan Vannordstrand, RN
• Carley Vanzile
• Alexandra Waite, RN
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3221)

• Mental Health Counselor in Watkins Glen, NY
• Providers in Watkins Glen, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.