Active NPI
Tyler Keidel
- Professional Counselor
- Colorado Springs, CO
National Provider Identifier
1992203657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPCC.0019368
- Practice address
- 1230 Tenderfoot Hill Rd
Colorado Springs, CO 80906-7346 - Phone
- (719) 694-1562
- NPI assigned
- Jan 29, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPCC.0019368 | CO | Primary |
Addresses
Primary practice location
1230 Tenderfoot Hill Rd
Colorado Springs, CO 80906-7346
Mailing address
12 Crystal Park Rd Unit 2
Manitou Springs, CO 80829-2183
Phone (719) 726-0231
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC.0019368 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1992203657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 CRYSTAL PARK RD UNIT 2",
"city": "MANITOU SPRINGS",
"state": "CO",
"postal_code": "808292183",
"telephone_number": "719-726-0231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 TENDERFOOT HILL RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809067346",
"telephone_number": "719-694-1562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEIDEL",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPCC.0019368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.