TYLER BRODERICK MS LPC NPI 1396080917

NPI Information

NPI: 1396080917
Provider Name: TYLER BRODERICK, MS, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

PECOS Registration: Yes

Address:
521 W LOTT ST
BUFFALO, WY
ZIP 82834
Phone: (307) 684-5531
Get Directions

Tyler Broderick, MS, LPC is a professional counselor in Buffalo, WY. Tyler Broderick, MS, LPC NPI is 1396080917. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

521 W LOTT ST
BUFFALO, WY
ZIP 82834-642
Phone: (307) 684-5531
Fax: (307) 684-2912

The NPI 1396080917 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/7/2012 and was last updated on 7/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	PPC721	WYOMING	No
2	101YP2500X	Counselor	Professional	LPC-1434	WYOMING	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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