Active NPI
Amy Tyler
- Counselor
- Canton, OH
National Provider Identifier
1699135574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C1800909
- Practice address
- 601 Cleveland Ave NW
Canton, OH 44702-1836 - Phone
- (330) 455-0374
- Fax
- (330) 453-6716
- NPI assigned
- Mar 4, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | C1800909 | OH | Primary |
Addresses
Primary practice location
601 Cleveland Ave NW
Canton, OH 44702-1836
Mailing address
625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 455-0374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 25, 2024 through Jan 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1800909 | OH | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536796800000",
"number": "1699135574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 CLEVELAND AVE NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447021805",
"telephone_number": "330-455-0374",
"fax_number": "330-453-6716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CLEVELAND AVE NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447021836",
"telephone_number": "330-455-0374",
"fax_number": "330-453-6716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-04",
"last_updated": "2018-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "C1800909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.