Individual
TYLER ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
246 NORTHLAND DR STE 200A, MEDINA, OH 44256-3440
(330) 725-9195
(330) 725-9187
Mailing address
246 NORTHLAND DR STE 200A, MEDINA, OH 44256-3440
(330) 725-9195
(330) 725-9187
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.2507280
OH
171M00000X
Case Manager/Care Coordinator
—
OH
390200000X
Student in an Organized Health Care Education/Training Program
C.2405853-TRNE
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128769
—
OH
05
—
2910854
—
OH
Enumeration date
08/09/2023
Last updated
11/13/2025
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