Active NPI
Donald Tyler III, LSAA
- Addiction (Substance Use Disorder) Counselor
- Rio Rancho, NM
National Provider Identifier
1710772249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CTB-2024-0663
- Practice address
- 1712 Golf Course Rd SE
Rio Rancho, NM 87124-1763 - Phone
- (505) 850-7103
- NPI assigned
- Apr 14, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CTB-2024-0663 | NM | Primary |
Addresses
Primary practice location
1712 Golf Course Rd SE
Rio Rancho, NM 87124-1763
Mailing address
1712 Golf Course Rd SE
Rio Rancho, NM 87124-1763
Phone (505) 850-7103
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CTB-2024-0663 | NM | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744588800000",
"number": "1710772249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1712 GOLF COURSE RD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241763",
"telephone_number": "505-850-7103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1712 GOLF COURSE RD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241763",
"telephone_number": "505-850-7103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER",
"first_name": "DONALD",
"name_suffix": "III",
"credential": "LSAA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-14",
"last_updated": "2025-04-14",
"certification_date": "2025-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "CTB-2024-0663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.