| Tyler Beam LLC | |
|
1300 E 15th St Ste 130 Edmond OK 73013 | |
| (405) 934-5013 | |
| Not Available |
| Full Name | Tyler Beam LLC |
|---|---|
| Speciality | Counselor |
| Location | 1300 E 15th St Ste 130, Edmond, Oklahoma |
| Authorized Official Name and Position | Tyle Beam (OWNER) |
| Authorized Official Contact | 4059345013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Beam LLC 1300 E 15th St Ste 130 Edmond OK 73013 Ph: (405) 934-5013 | Tyler Beam LLC 1300 E 15th St Ste 130 Edmond OK 73013 Ph: (405) 934-5013 |
| NPI Number | 1376435982 |
|---|---|
| Provider Enumeration Date | 07/17/2025 |
| Last Update Date | 07/17/2025 |
| Certification Date | 07/17/2025 |
| Medicare PECOS PAC ID | 2163929662 |
|---|---|
| Medicare Enrollment ID | O20251009003460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376435982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Tyler Beam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144952078 PECOS PAC ID: 3072010578 Enrollment ID: I20251009003574 |
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