| Tyler Kackley, LPCMH | |
|
735 Mapleton Ave Ste 200, Middletown, DE 19709-1560 | |
| (302) 224-1400 | |
| (302) 224-1402 |
| Full Name | Tyler Kackley |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 735 Mapleton Ave Ste 200, Middletown, Delaware |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033870308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PC-0011149 (Delaware) | Primary |
| Entity Name | Mid-atlantic Behavioral Health, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871719872 PECOS PAC ID: 3375620016 Enrollment ID: O20080407000009 |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Kackley, LPCMH 910 S Chapel St Ste 102, Newark, DE 19713-3468 Ph: (302) 224-1400 | Tyler Kackley, LPCMH 735 Mapleton Ave Ste 200, Middletown, DE 19709-1560 Ph: (302) 224-1400 |
Mary C. Fenimore, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 118 Sandhill Dr Ste 202, Middletown, DE 19709 Phone: 302-674-2380 Fax: 302-376-6212 | |
Mrs. Laurie Ann Denham, LPCMH Counselor Medicare: Not Enrolled in Medicare Practice Location: 252 Carter Dr, Middletown, DE 19709 Phone: 302-738-6859 Fax: 302-368-5309 | |
Mrs. Sandra Lee Knauer-king, MSW Counselor Medicare: Medicare Enrolled Practice Location: 401 N Broad St, Middletown, DE 19709 Phone: 302-376-0621 Fax: 302-376-6219 | |
Sarah Anne Kenny, LACMH Counselor Medicare: Not Enrolled in Medicare Practice Location: 735 Mapleton Ave Ste 200, Middletown, DE 19709 Phone: 302-563-8713 | |
Ms. Angie C Walker, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 153 Shannon Blvd, Middletown, DE 19709 Phone: 302-981-3851 | |
Brittanee King, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 364 E Main St Ste 184, Middletown, DE 19709 Phone: 302-563-5140 |