Stacy Tylor, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05816 Issued in MD

Practice address

60 Market St
#213
Gaithersburg, MD 20878-6548

Phone

(240) 750-6467

NPI assigned

Oct 14, 2010

Sex

Female

Sole proprietor

Yes

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)

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.

• Prosperity Behavioral Healthcare, PLLC

  • Psychologist
  • Manassas, VA
  • NPI 1679234744
  NPD Authorized official

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1992015887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MARKET ST",
            "address_2": "#213",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208786548",
            "telephone_number": "240-750-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MARKET ST",
            "address_2": "#213",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208786548",
            "telephone_number": "240-750-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLOR",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Turner
• Shanya Kelly Turner
• Jean Alexandra Tuttle, LCSW-C
• Monika Marie Twardzik-Roberts, MPT
• Michelle Ekua Serwaa Tweedie, PA-C
• Judy Ann Tyson, PH.D.
• Norman David Tzou, MD
• U.S. Medgroup P.a.
• Ucare Agency LLC
• Favour Uchegbu-Rufus

• Clinical Psychologist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.