Tyler Smith Buckhout, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

127377 Issued in MA

Practice address

294 Bowdoin St
Dorchester, MA 02122-1814

Phone

(617) 388-7885

NPI assigned

Feb 1, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tyler Buckhout, Licsw, LLC

  • Adult Mental Health Clinic/Center
  • East Boston, MA
  • NPI 1760253058
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1013455823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HAYNES ST UNIT 101",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021284952",
            "telephone_number": "978-387-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 BOWDOIN ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021221814",
            "telephone_number": "617-388-7885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Man Mar Dr",
            "address_purpose": "LOCATION",
            "city": "Plainville",
            "state": "MA",
            "postal_code": "027622270",
            "country_code": "US",
            "telephone_number": "781-436-2025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKHOUT",
        "first_name": "TYLER",
        "middle_name": "SMITH",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-01",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "127377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon D Brown
• Dorothy Brozek, MD
• BT Chiropractic Health Center, Inc.
• Liana Buccieri, LICSW
• Nancy Bucken, RN
• Ying Buckley, PA
• David Stanley Buczak, DMD
• Vivian Bui, DPT
• Sharlene Teresa Bullock, LMHC
• Jessica Hart Burch

• Clinical Social Worker in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.