Provider Demographics
NPI:1063945459
Name:DEAL, TYLER ALLEASE (LPCA, NCC)
Entity type:Individual
Prefix:MS
First Name:TYLER
Middle Name:ALLEASE
Last Name:DEAL
Suffix:
Gender:F
Credentials:LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 TAMBRAS WAY
Mailing Address - Street 2:
Mailing Address - City:VILAS
Mailing Address - State:NC
Mailing Address - Zip Code:28692-6011
Mailing Address - Country:US
Mailing Address - Phone:828-773-1365
Mailing Address - Fax:
Practice Address - Street 1:577 GEORGE WILSON RD # 4
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-8667
Practice Address - Country:US
Practice Address - Phone:828-767-9942
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12147101Y00000X
NC12147101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional