Tyler Charles Smith, LPC, CSAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10088125 Issued in WI

Practice address

7957 W Wind Lake Rd Ste E
Waterford, WI 53185-2234

Phone

(608) 561-8656

NPI assigned

May 11, 2024

Last updated

May 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• My Time Counseling Services, Inc.

  • Professional Counselor
  • Waterford, WI
  • NPI 1093496283

  Addiction (Substance Use Disorder)

  NPD
• Rogers Memorial Hospital Incorporated

  dba Rogers Behavioral Health

  • Psychiatric Hospital
  • Oconomowoc, WI
  • NPI 1053329581
  NPD (past)

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

{
    "created_epoch": "1715385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715385600000",
    "number": "1316795503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7957 W WIND LAKE RD STE E",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531852234",
            "telephone_number": "608-561-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7957 W WIND LAKE RD STE E",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531852234",
            "telephone_number": "608-561-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYLER",
        "middle_name": "CHARLES",
        "credential": "LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-11",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17132132",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "10088125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly A Sennett, SLP
• Dawn Shuda, PT
• R Ann Sievers, SLP
• Brenna Smith, DPT
• Melanie A Smith, DO
• Jaia Sojka
• Cynthia D Sorenson, PHD
• Callie Spaulding
• Alok K Srivastava, MD
• St George Clinics, LLC

• Mental Health Counselor in Waterford, WI
• Providers in Waterford, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.