Mr Christopher Colgan Tyler, | |
1190 E Broadway, Louisville, KY 40204-1712 | |
(502) 627-0905 | |
Not Available |
Full Name | Mr Christopher Colgan Tyler |
---|---|
Gender | Male |
Speciality | Clinical Social Worker |
Experience | 19 Years |
Location | 1190 E Broadway, Louisville, Kentucky |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497935324 | NPI | - | NPPES |
3316 | Other | KY | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 3316 (Kentucky) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mandala House, Llc | 4789957135 | 9 |
Entity Name | Mandala House, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659829760 PECOS PAC ID: 4789957135 Enrollment ID: O20170906002088 |
Mailing Address | Practice Location Address |
---|---|
Mr Christopher Colgan Tyler, 1190 E Broadway, Louisville, KY 40204-1712 Ph: (502) 627-0905 | Mr Christopher Colgan Tyler, 1190 E Broadway, Louisville, KY 40204-1712 Ph: (502) 627-0905 |
Jennifer L Buckland-stern, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Dsi, 635 S. Third St., Louisville, KY 40202 Phone: 502-561-1314 Fax: 502-561-1840 | |
Julie Eifler Corbett, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10101 Linn Station Rd Ste 600, Louisville, KY 40223 Phone: 502-589-8600 Fax: 502-287-0062 | |
Shaquilla N Cooper, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1828 Bolling Ave, Louisville, KY 40210 Phone: 502-536-7245 Fax: 502-963-5135 | |
Mary O'shea, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1169 Eastern Pkwy Ste 1166, Louisville, KY 40217 Phone: 502-451-8262 | |
Ms. Lisa Shapiro, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8135 New Lagrange Rd, Louisville, KY 40222 Phone: 502-451-7602 | |
Ms. Elizabeth Ann Alvarado, CSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 950 S 1st St, Louisville, KY 40203 Phone: 502-585-9444 Fax: 502-585-9466 | |
David Huey Cook, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 455 S 4th St Ste 842, Louisville, KY 40202 Phone: 502-584-7216 Fax: 502-585-5373 |