Tyler John Marx, LPC-IT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7976-226 Issued in WI

Practice address

207 N Spring St
Beaver Dam, WI 53916-2115

Phone

(920) 382-0445

NPI assigned

Jun 19, 2024

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Unmasked Expressive Therapies

  • Mental Health Counselor
  • Beaver Dam, WI
  • NPI 1407349657
  NPD (past)

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1437993029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 S FAIRFIELD AVE",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "530391050",
            "telephone_number": "920-382-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N SPRING ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162115",
            "telephone_number": "920-382-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "TYLER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LPC-IT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7976-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Beaver Dam, WI
• Providers in Beaver Dam, 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 Jun 19, 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.