Individual provider Active NPI

Lennon Tyler, PSYD

  • Psychologist
  • Las Vegas, NV
National Provider Identifier
1477039345
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY-2196 Issued in HI
Practice address
7609 Advantage CT
Las Vegas, NV 89129-6736
Phone
(808) 265-8303
NPI assigned
Jul 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY-2196 HI Primary

Addresses

Primary practice location

7609 Advantage CT
Las Vegas, NV 89129-6736

Mailing address

7609 Advantage CT
Las Vegas, NV 89129-6736
Phone (808) 265-8303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2450 Fondren Rd
Suite 312
Houston, TX 77063-2316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY-2196HIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy of Southern Nevada LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1477039345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 ADVANTAGE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296736",
            "telephone_number": "808-265-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7609 ADVANTAGE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296736",
            "telephone_number": "808-265-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "LENNON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY-2196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.