Provider Demographics
NPI:1235628199
Name:FYLER, ADAM (MT-BC, LPCC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:FYLER
Suffix:
Gender:M
Credentials:MT-BC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 S BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4220
Mailing Address - Country:US
Mailing Address - Phone:785-865-6555
Mailing Address - Fax:
Practice Address - Street 1:548 FRONT ST
Practice Address - Street 2:
Practice Address - City:FAIRPLAY
Practice Address - State:CO
Practice Address - Zip Code:80440-5001
Practice Address - Country:US
Practice Address - Phone:785-865-6555
Practice Address - Fax:844-265-8622
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015836101YM0800X
CO13551225A00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist