Individual provider Active NPI

Tyler W Secor, LPC

  • Professional Counselor
  • Kenosha, WI
National Provider Identifier
1740840420
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8580125 Issued in WI
Practice address
4006 Washington Rd
Kenosha, WI 53144-4819
Phone
(262) 656-0044
Fax
(262) 649-1977
NPI assigned
Jun 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8580125 WI Primary

Addresses

Primary practice location

4006 Washington Rd
Kenosha, WI 53144-4819

Mailing address

4006 Washington Rd
Kenosha, WI 53144-4819
Phone (262) 656-0044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240429001583 WI Practitioner - Mental Health Counselor 0648610345 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Alarus Healthcare LLCGroup PAC ID 8022231026, 11 clinicians
Kenosha Community Health Center, Inc.Group PAC ID 0941195168, 19 clinicians

Practice addresses (Care Compare)

1971 Washington St
Suite 200
Grafton, WI 53024-2125
Phone (262) 377-6276

903 S 2ND St
Silver Lake, WI 53170-1747
Phone (262) 656-0044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8580125WIMDProfessional Counselor
8580WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kenosha Community Health Center, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Alarus Healthcare, LLC CurrentSince Apr 16, 2024 Accepting new patients
Kenosha Community Health Center, Inc. Mental Health Current Accepting new patients
Living for Liberation PastSince Feb 26, 2023 Accepting new patients
Alarus Home Health LLC PastSince Apr 16, 2024 Accepting new patients

Locations

111 Warren St
Ste 2
Beaver Dam, WI 53916
Phone (920) 216-4440

1971 Washington St
Ste 200
Grafton, WI 53024
Phone (262) 377-6276

4006 Washington Rd
Kenosha, WI 53144
Phone (262) 652-4006

4536 22nd Ave
Kenosha, WI 53140
Phone (262) 656-0044

1622 Chestnut St
West Bend, WI 53095
Phone (262) 306-9800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1740840420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444819",
            "telephone_number": "262-656-0044",
            "fax_number": "262-649-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444819",
            "telephone_number": "262-656-0044",
            "fax_number": "262-649-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECOR",
        "first_name": "TYLER",
        "middle_name": "W",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-16",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8580125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.