Individual provider Active NPI

Lisa Ann Tyler, LMHC NBCC

  • Mental Health Counselor
  • Penfield, NY
National Provider Identifier
1740731629
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001227-1 Issued in NY
Practice address
61 Brantley Way
Penfield, NY 14526-2852
Phone
(585) 370-3085
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 001227-1 NY Primary

Addresses

Primary practice location

61 Brantley Way
Penfield, NY 14526-2852

Mailing address

61 Brantley Way
Penfield, NY 14526-2852
Phone (585) 370-3085

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

LicenseStateTypeSpecialty
001227-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1740731629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 BRANTLEY WAY",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262852",
            "telephone_number": "585-370-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BRANTLEY WAY",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262852",
            "telephone_number": "585-370-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMHC NBCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001227-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.