Provider Demographics
NPI:1801436688
Name:REKOWSKI, TYLER ROBERT (LPCC)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:ROBERT
Last Name:REKOWSKI
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 JORDAN AVE S APT 202
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-3504
Mailing Address - Country:US
Mailing Address - Phone:651-728-6400
Mailing Address - Fax:952-448-6047
Practice Address - Street 1:2828 JORDAN AVE S APT 202
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-3504
Practice Address - Country:US
Practice Address - Phone:715-651-4115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7848-125101YM0800X
MNCC02273101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health