Provider Demographics
NPI:1568258051
Name:ROBINSON, TYLER
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18907 SAINT ALBERT DR
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-3261
Mailing Address - Country:US
Mailing Address - Phone:301-281-7497
Mailing Address - Fax:
Practice Address - Street 1:10400 LITTLE PATUXENT PKWY STE 305
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3518
Practice Address - Country:US
Practice Address - Phone:410-210-4098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16350101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional