Tyler Massie, LMFT

Individual provider Active NPI Marriage & Family Therapist · Chester, CT

NPI 1831541937 · NPPES record last updated Jul 13, 2016

Key facts

NPI
1831541937
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
1810 (CT)
Practice address
64 Wig Hill Rd
Chester, CT 06412-1124
Phone
(860) 917-5785
NPI assigned
Jul 13, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1810CTMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1810 CT Yes

Addresses

Primary practice location

64 Wig Hill Rd
Chester, CT 06412-1124

Mailing address

64 Wig Hill Rd
Chester, CT 06412-1124

Other providers in Chester, CT

All providers in Chester, CT · Marriage & Family Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.