Provider Demographics
NPI:1356827760
Name:WINKLEPLECK, TYLER SCOTT
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:SCOTT
Last Name:WINKLEPLECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 22 6028 STATE ROUTE 54
Mailing Address - Street 2:
Mailing Address - City:PHILPOT
Mailing Address - State:KY
Mailing Address - Zip Code:42366
Mailing Address - Country:US
Mailing Address - Phone:270-316-0740
Mailing Address - Fax:
Practice Address - Street 1:2816 VEACH RD STE 208
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-6299
Practice Address - Country:US
Practice Address - Phone:270-228-3040
Practice Address - Fax:270-228-0341
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009165A1041C0700X
KY2534131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty