Provider Demographics
NPI:1538562285
Name:BYRD, TYLER P (LMHP)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:P
Last Name:BYRD
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 N 144TH ST
Mailing Address - Street 2:STE 4
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4715
Mailing Address - Country:US
Mailing Address - Phone:402-915-1061
Mailing Address - Fax:402-614-6174
Practice Address - Street 1:1710 N 144TH ST
Practice Address - Street 2:STE 4
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4715
Practice Address - Country:US
Practice Address - Phone:402-915-1061
Practice Address - Fax:402-614-6174
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10336101Y00000X
NE4758101Y00000X
NE2289101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor