Tyler Jack Kilbane, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2497 Issued in WV

Practice address

1031 National Rd
Wheeling, WV 26003-5709

Phone

(740) 293-4050

NPI assigned

Feb 9, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Known by Name Counseling Services, LLC

  • Mental Health Counselor
  • Wheeling, WV
  • NPI 1164287546
  NPD Authorized official

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1801395363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 EDGWOOD STREET",
            "address_2": "APT 1",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-238-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 NATIONAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035709",
            "telephone_number": "740-293-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBANE",
        "first_name": "TYLER",
        "middle_name": "JACK",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-09",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2497",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WHEELING",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "WHEELING",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "WHEELING",
            "address_1": "125 Edgwood St",
            "city": "Wheeling",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260036093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WHEELING",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "WHEELING",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "WHEELING",
            "address_1": "1031 National Rd",
            "city": "Wheeling",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260035709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Wheeling, WV
• Providers in Wheeling, WV by specialty
• Mental Health Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.