Individual provider · Type 1 NPI

Tyler Wesley Stull, LCPC CADC

Professional Counselor · Rockford, IL

NPI number 1407446636 Active

Practice location

1200 W State St
Rockford, IL 61102-2112

Call (815) 490-1600 Map

Fax (815) 490-1881

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X29194 (IL)
Professional Counselor Primary 101YP2500X180011338 (IL)

Professional Counselor: Definition to come...

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About NPI 1407446636

Tyler Wesley Stull, LCPC CADC's National Provider Identifier is 1407446636, issued on Jan 21, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Rockford, IL. The record was last updated on Oct 24, 2023.