Tyler Broderick, MS, LPC
NPI 1396080917ActiveIndividual· Counselor, Professional· Buffalo, WY
Counselor, Professional (MS, LPC) in Buffalo, Wyoming, licensed in WY, with an NPI issued in December 2012.
Overview
| NPI | 1396080917 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS, LPC |
| Sole proprietor | No |
| NPI issued | Dec 7, 2012 |
| Last updated in NPPES | Jul 9, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | LPC-1434 | WY |
| Counselor, Mental Health | 101YM0800X | PPC721 | WY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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