Individual provider Active NPI

Tyler B Coleman, MA, LCPC, LAC

  • Professional Counselor
  • Missoula, MT
National Provider Identifier
1184781221
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1041 Issued in MT
Practice address
2825 Stockyard Rd Ste A22
Missoula, MT 59808-1546
Phone
(406) 396-5910
NPI assigned
Jan 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 664 MT
Professional Counselor 101YP2500X 1041 MT Primary

Addresses

Primary practice location

2825 Stockyard Rd Ste A22
Missoula, MT 59808-1546

Mailing address

1107 Lincolnwood Rd
Missoula, MT 59802-3037
Phone (406) 396-5910

Other identifiers 2

IdentifierTypeStateIssuer
742530OtherMTBLUECROSS BLUESHIELD
0256880MedicaidMT

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1184781221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 LINCOLNWOOD RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023037",
            "telephone_number": "406-396-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE A22",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081546",
            "telephone_number": "406-396-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "TYLER",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "MA, LCPC, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "664",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "1041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "742530",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0256880",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.