Individual provider Active NPI

Tylor Vincent, MFT, ADHD-CCSP

  • Marriage & Family Therapist
  • Wadsworth, OH
National Provider Identifier
1972306249
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M.2400297 Issued in OH
Practice address
180 High St Ste C
Wadsworth, OH 44281-1874
Phone
(330) 331-9203
NPI assigned
Mar 31, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X M.2400297 OH Primary

Addresses

Primary practice location

180 High St Ste C
Wadsworth, OH 44281-1874

Mailing address

3093 Holly Dr
Brunswick, OH 44212-3729

Other practice location 1

30400 Detroit Rd Ste 30
Westlake, OH 44145-1872
Phone (440) 250-8868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20260408001415 OH Practitioner - Marriage and Family Therapist 5193290054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

30400 Detroit Rd
Suite 301
Westlake, OH 44145-1855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M.2400297OHMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Behavioral Specialists LLC Past Accepting new patients

Organizations & group practices 1

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1972306249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3093 HOLLY DR",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442123729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 HIGH ST STE C",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442811874",
            "telephone_number": "330-331-9203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30400 Detroit Rd Ste 30",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441451872",
            "country_code": "US",
            "telephone_number": "440-250-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "TYLOR",
        "credential": "MFT, ADHD-CCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M.2400297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.