Provider Demographics
NPI:1386212405
Name:ATKINSON, TYLER (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140413
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80214-0413
Mailing Address - Country:US
Mailing Address - Phone:720-593-9727
Mailing Address - Fax:
Practice Address - Street 1:10190 BANNOCK ST STE 120
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80260-6052
Practice Address - Country:US
Practice Address - Phone:720-593-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health