Tyler Stickle, M.ED., LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1243 Issued in KY

Practice address

207 Parker Dr Unit 2B
La Grange, KY 40031-1269

Phone

(502) 418-3469

NPI assigned

Feb 1, 2011

Last updated

May 19, 2022By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Wellfront Readiness Solutions

  • Mental Health Counselor
  • La Grange, KY
  • NPI 1407354053
  NPD (past) Authorized official

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1669778122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 BURNT HILL RD",
            "city": "GOSHEN",
            "state": "KY",
            "postal_code": "400269553",
            "telephone_number": "502-418-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 PARKER DR UNIT 2B",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400311269",
            "telephone_number": "502-418-3469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5135 Dixie Hwy Ste 15C",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402161771",
            "country_code": "US",
            "telephone_number": "502-418-3469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1206 Burnt Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "KY",
            "postal_code": "400269553",
            "country_code": "US",
            "telephone_number": "502-418-3469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STICKLE",
        "first_name": "TYLER",
        "credential": "M.ED., LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-01",
        "last_updated": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "1243",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "1243",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH",
            "identifier": "600863657",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in La Grange, KY
• Providers in La Grange, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.