Tyson Blake Prouse, M.S., T-LMLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

T-LMLP 1146 Issued in KS

Practice address

120 S Gordy St Ste 3
El Dorado, KS 67042-2900

Phone

(316) 321-6088

Fax

(316) 321-3957

NPI assigned

Jan 10, 2008

Last updated

Jan 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brave Counseling and Consultation LLC

  • Clinical Psychologist
  • Emporia, KS
  • NPI 1285356030
  NPD Authorized official
• South Central Mental Health Counseling Center Inc

  • Addiction (Substance Use Disorder) Counselor
  • El Dorado, KS
  • NPI 1962608893
  NPD (past)

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1952587792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S GORDY ST STE 3",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422900",
            "telephone_number": "316-321-6088",
            "fax_number": "316-321-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S GORDY ST STE 3",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422900",
            "telephone_number": "316-321-6088",
            "fax_number": "316-321-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUSE",
        "first_name": "TYSON",
        "middle_name": "BLAKE",
        "name_prefix": "Mr.",
        "credential": "M.S., T-LMLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "T-LMLP 1146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jess Shirley Plummer, D.D.S.
• Nicholas J Posge, D.P.M.
• Cassandra Irene Pound
• Tera Price
• Debra Prim
• R.M. Moody,DDS/El Dorado
• Aubrey Shea Ralston, M.D.
• Marcus S Randall, OD
• William Spencer Rasband, DDS
• Rausch Medical Clinics, LLC (El Dorado Sports & Family Medicine)

• Clinical Psychologist in El Dorado, KS
• Providers in El Dorado, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.