1902945249 NPI number — AMERICAN HEALTH MANAGEMENT, INC.

Table of content: MICHAEL ALAN TYLLAS LCSW, PH.D. (NPI 1023688728)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902945249 NPI number — AMERICAN HEALTH MANAGEMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN HEALTH MANAGEMENT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902945249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 572
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40476-0572
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-623-4080
Provider Business Mailing Address Fax Number:
859-624-5771

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 FIRE HOUSE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HYDEN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41749-8637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-672-3551
Provider Business Practice Location Address Fax Number:
606-672-3552
Provider Enumeration Date:
02/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
UPCHURCH
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
859-623-4080

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43000710 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".