Provider Demographics
NPI:1093699852
Name:TYLER, LORAN MAKENZIE (MS, LPC-A)
Entity type:Individual
Prefix:
First Name:LORAN
Middle Name:MAKENZIE
Last Name:TYLER
Suffix:
Gender:F
Credentials:MS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WOODLAND ST APT C
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-2058
Mailing Address - Country:US
Mailing Address - Phone:912-540-0230
Mailing Address - Fax:
Practice Address - Street 1:313 NORTHWEST RENFRO STREET
Practice Address - Street 2:105
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028
Practice Address - Country:US
Practice Address - Phone:817-527-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94141101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor