Tyler Elliott

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C.2507280 Issued in OH

Practice address

246 Northland Dr Ste 200a
Medina, OH 44256-3440

Phone

(330) 725-9195

Fax

(330) 725-9187

NPI assigned

Aug 9, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1558044321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR STE 200A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563440",
            "telephone_number": "330-725-9195",
            "fax_number": "330-725-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR STE 200A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563440",
            "telephone_number": "330-725-9195",
            "fax_number": "330-725-9187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "246 Northland Dr Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442563440",
            "country_code": "US",
            "telephone_number": "330-725-9195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "C.2405853-TRNE",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2507280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128769",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Medina, OH
• Providers in Medina, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.