Provider Demographics
NPI:1063964716
Name:TALBERT, TYLER LEIGH-ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:TYLER
Middle Name:LEIGH-ANN
Last Name:TALBERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TYLER
Other - Middle Name:LEIGH-ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:227 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-3058
Practice Address - Country:US
Practice Address - Phone:970-572-3681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12419101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional