Individual provider Active NPI

Derek Jamal Tyler Sr.

  • Mental Health Counselor
  • Virginia Beach, VA
National Provider Identifier
1982513701
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0704019489 Issued in VA
Practice address
3704 Pacific Ave Ste 300
Virginia Beach, VA 23451-2719
Phone
(757) 222-4944
NPI assigned
Sep 7, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0704019489 VA Primary

Addresses

Primary practice location

3704 Pacific Ave Ste 300
Virginia Beach, VA 23451-2719

Mailing address

705 Dissdale LN
Chesapeake, VA 23320-6859
Phone (504) 931-7110

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1982513701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 DISSDALE LN",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233206859",
            "telephone_number": "504-931-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 PACIFIC AVE STE 300",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234512719",
            "telephone_number": "757-222-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "DEREK",
        "middle_name": "JAMAL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0704019489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.