Active NPI
Lauren Kimball Tyler, LPCC
- Professional Counselor
- Edgewood, NM
National Provider Identifier
1104129766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CCMH0156401
- Practice address
- 7 Glitter Gulch Way
Edgewood, NM 87015-8738 - Phone
- (970) 739-4626
- NPI assigned
- Dec 20, 2010
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CCMH0156401 | NM | Primary |
Addresses
Primary practice location
7 Glitter Gulch Way
Edgewood, NM 87015-8738
Mailing address
7 Glitter Gulch Way
Edgewood, NM 87015-8738
Phone (970) 739-4626
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 |
|---|---|---|---|
| CCMH0156401 | NM | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748131200000",
"number": "1104129766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 GLITTER GULCH WAY",
"city": "EDGEWOOD",
"state": "NM",
"postal_code": "870158738",
"telephone_number": "970-739-4626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 GLITTER GULCH WAY",
"city": "EDGEWOOD",
"state": "NM",
"postal_code": "870158738",
"telephone_number": "970-739-4626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER",
"first_name": "LAUREN",
"middle_name": "KIMBALL",
"name_prefix": "Ms.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-20",
"last_updated": "2025-05-25",
"certification_date": "2025-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "NM",
"license": "CCMH0156401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edgewood, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.