Provider Demographics
NPI:1295496529
Name:FYOTEK, TYLER JOHNSON (TLMHC, NCC)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JOHNSON
Last Name:FYOTEK
Suffix:
Gender:M
Credentials:TLMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E COLLEGE ST STE 211
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1759
Mailing Address - Country:US
Mailing Address - Phone:530-520-5046
Mailing Address - Fax:
Practice Address - Street 1:221 E COLLEGE ST STE 211
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1759
Practice Address - Country:US
Practice Address - Phone:530-520-5046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA105877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health