Individual provider Active NPI

Melinda Mary Tyler, MA, MFT

  • Marriage & Family Therapist
  • Preston, CT
National Provider Identifier
1235429754
Registry record updated Mar 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
84 River Rd
Preston, CT 06365-8023
Phone
(860) 639-4953
Fax
(888) 509-7271
NPI assigned
Apr 18, 2011
Last updated
Mar 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

84 River Rd
Preston, CT 06365-8023

Mailing address

84 River Rd
Preston, CT 06365-8023
Phone (860) 639-4953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20250211001847 CT Practitioner - Marriage and Family Therapist 1850821562 Practice locations: Preston, CT

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Preston, CT 06365
Phone (860) 326-4148

84 River Rd
Preston, CT 06365-8023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
001621CTMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425686400000",
    "number": "1235429754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 RIVER RD",
            "city": "PRESTON",
            "state": "CT",
            "postal_code": "063658023",
            "telephone_number": "860-639-4953",
            "fax_number": "888-509-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 RIVER RD",
            "city": "PRESTON",
            "state": "CT",
            "postal_code": "063658023",
            "telephone_number": "860-639-4953",
            "fax_number": "888-509-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "MELINDA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2015-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Preston, CT

Sources for this page

Verify at the official NPI Registry.