Provider Demographics
NPI:1265770879
Name:STAPLES, TYLER D (PSYD)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:D
Last Name:STAPLES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8456 MAURER RD
Mailing Address - Street 2:APT. 837
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-2736
Mailing Address - Country:US
Mailing Address - Phone:913-269-9621
Mailing Address - Fax:
Practice Address - Street 1:25055 W VALLEY PKWY STE 220
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-8450
Practice Address - Country:US
Practice Address - Phone:913-378-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03275T103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist