Provider Demographics
NPI:1861825531
Name:DR TYREE BRINSON & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DR TYREE BRINSON & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TYREE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-727-9417
Mailing Address - Street 1:2601 LINCOLN HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3506 IONIA AVE
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1315
Practice Address - Country:US
Practice Address - Phone:773-727-9417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-008540103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty