Provider Demographics
NPI:1760859425
Name:CONNER, TYLER ALLEN (MA, LMHC)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:ALLEN
Last Name:CONNER
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 N ORANGE AVE APT 5405
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-7323
Mailing Address - Country:US
Mailing Address - Phone:407-810-8319
Mailing Address - Fax:
Practice Address - Street 1:228 ANNIE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1208
Practice Address - Country:US
Practice Address - Phone:407-810-8319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health