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TYLER WESLEY STULL LCPC CADC
NPI 1407446636
Counselor - Professional in Rockford, IL

Active since January 21, 2021PECOS Enrolled
1200 W STATE ST, ROCKFORD, IL 61102(815) 490-1600(815) 490-1881 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 24, 2023, Feb 2, 2021, Jan 21, 2021 (3 updates tracked since 2021).

About Tyler Wesley Stull Lcpc Cadc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER WESLEY STULL LCPC CADC (NPI 1407446636) is an individual professional provider in Rockford, Illinois, licensed in Illinois (180011338) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407446636
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameTYLER WESLEY STULLCredential: LCPC CADC
Location Address1200 W STATE STRockford, IL 61102-2112
Mailing Address1200 W State StRockford, IL 61102-2112 · (815) 490-1600
Phone(815) 490-1600
Fax(815) 490-1881
Sole ProprietorYes
Enumeration DateJanuary 21, 2021
Last NPPES UpdateOctober 24, 20233 updates tracked since enumeration
NPPES CertifiedOctober 24, 2023
✔ NPI 1407446636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180011338
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 29194 (IL)
1200 W STATE ST, Rockford, IL 61102
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyler Wesley Stull Lcpc Cadc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARYN ANN RUZIC APRN
Nurse Practitioner (Family)
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
DR. JOHN WALL MD
Family Medicine
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
DR. ADEKOLA ABIOUDUN ASHAYE MD
Internal Medicine
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
DR. GARY PATRICK FERNANDO MD
Pediatrics
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
CRISTINA DIVENTI LSW
Social Worker
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
CORNITA CANNON M.D.
Obstetrics & Gynecology
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
LAURA PEREZ CNM, APRN
Advanced Practice Midwife
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
KERIN CUMMINS APN
Nurse Practitioner (Family)
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Stull's NPI number?

The NPI number for Tyler Stull is 1407446636. It was assigned to this individual provider in the NPPES registry on January 21, 2021.

Where is Tyler Stull located?

Tyler Stull practices at 1200 W State St, Rockford, IL 61102. The listed phone number is (815) 490-1600.

What is Tyler Stull's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Tyler Stull enrolled in Medicare?

Yes. Tyler Stull is registered in the Medicare PECOS enrollment system.

What insurance does Tyler Stull accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and MercyCare Health Plans list Tyler Stull as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tyler Stull was last updated on October 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.