Provider Demographics
NPI:1801268396
Name:OBERHEIM, STEVEN TYLER (PHD, LMHC (FL), NCC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:TYLER
Last Name:OBERHEIM
Suffix:
Gender:M
Credentials:PHD, LMHC (FL), NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1224
Mailing Address - Street 2:
Mailing Address - City:NORRIS
Mailing Address - State:TN
Mailing Address - Zip Code:37828-1224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 RIDGEWAY RD
Practice Address - Street 2:
Practice Address - City:NORRIS
Practice Address - State:TN
Practice Address - Zip Code:37828
Practice Address - Country:US
Practice Address - Phone:865-247-5196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16087101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health