Provider Demographics
NPI:1407555089
Name:WHITE, TYLER (LPCC)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 S COLORADO BLVD # 1172
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2080
Mailing Address - Country:US
Mailing Address - Phone:720-441-3201
Mailing Address - Fax:
Practice Address - Street 1:6901 S PIERCE ST STE 235
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-7206
Practice Address - Country:US
Practice Address - Phone:720-441-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0020038101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional