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Individual

CARL MICHAEL TIERNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RMHCI

Contact information

Practice address
2479 ALOMA AVE, WINTER PARK, FL 32792-2541
(407) 657-6692
(407) 894-6010
Mailing address
3208 CRYSTAL PARK CT, LEAGUE CITY, TX 77573-2248
(407) 587-6499

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH18616
FL
101YM0800X
Mental Health Counselor
Primary
MH25112
FL
101YP2500X
Professional Counselor
94563
TX

Other

Enumeration date
07/15/2019
Last updated
04/21/2026
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