Provider Demographics
NPI:1275077042
Name:ORR, TYLER (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:ORR
Suffix:
Gender:M
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 ROBIN HOOD DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3343
Mailing Address - Country:US
Mailing Address - Phone:423-284-3518
Mailing Address - Fax:
Practice Address - Street 1:6245 VANCE RD STE C
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-0309
Practice Address - Country:US
Practice Address - Phone:423-284-3518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health