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TYLER LEE BLACKSTOCK LLPC. CADC
NPI 1801439112
Counselor - Professional in Plymouth, MI

Active since October 21, 2019PECOS EnrolledAccepts Medicare Assignment
9401 N HAGGERTY RD, PLYMOUTH, MI 48170(734) 845-6010 Get Directions Write a Review

NPPES record last updated: March 13, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 13, 2023, Oct 21, 2019 (2 updates tracked since 2019).

About Tyler Lee Blackstock Llpc. Cadc NPPES

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

TYLER LEE BLACKSTOCK LLPC. CADC (NPI 1801439112) is an individual professional provider in Plymouth, Michigan, licensed in Michigan (6451022333) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1801439112
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameTYLER LEE BLACKSTOCKCredential: LLPC. CADC
Location Address9401 N HAGGERTY RDPlymouth, MI 48170-4696
Mailing AddressPo Box 1044Cadillac, MI 49601-6044
Phone(734) 845-6010
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 21, 2019
Last NPPES UpdateMarch 13, 20232 updates tracked since enumeration
NPPES CertifiedMarch 13, 2023
✔ NPI 1801439112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MI · 6451022333
9401 N HAGGERTY RD, Plymouth, MI 48170
Open in Google Maps ↗

Other Identifiers 1

OtherB423809497452MI · Driver License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community 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 and accepts Medicare assignment

Tyler Lee Blackstock Llpc. Cadc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426582446
PECOS Enrollment IDI20241113004488
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 5

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

KIMBERLY COOPER
Counselor
9401 N HAGGERTY RD
PLYMOUTH, MI 48170
Wayne County (734) 927-1201
MRS. CAROL ANN MCCONNELL MA, LLPC
Counselor (Mental Health)
9401 N HAGGERTY RD
PLYMOUTH, MI 48170
Wayne County (734) 927-1201
JOHN WEIDMAN MACP, LLPC
Counselor
9401 N HAGGERTY RD
PLYMOUTH, MI 48170
Wayne County (734) 927-1201
MS. ABBIE MARIE WALTERS MSW
Social Worker (Clinical)
9401 N HAGGERTY RD
PLYMOUTH, MI 48170
Wayne County (734) 301-7668
MRS. MARCELLA AILEEN KRYKA LLMSW
Social Worker (Clinical)
9401 N HAGGERTY RD
PLYMOUTH, MI 48170
Wayne County (734) 730-4441

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 Blackstock's NPI number?

The NPI number for Tyler Blackstock is 1801439112. It was assigned to this individual provider in the NPPES registry on October 21, 2019.

Where is Tyler Blackstock located?

Tyler Blackstock practices at 9401 N Haggerty Rd, Plymouth, MI 48170. The listed phone number is (734) 845-6010.

What is Tyler Blackstock's specialty?

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

Is Tyler Blackstock enrolled in Medicare?

Yes. Tyler Blackstock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tyler Blackstock accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Oscar Insurance Company and Priority Health and 1 other insurer list Tyler Blackstock 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 Blackstock was last updated on March 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.