Active NPI
Tyler M Mitchell
- Developmental Therapist
- Milford, MA
National Provider Identifier
1043961089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 300 E Main St
Milford, MA 01757-2806 - Phone
- (508) 478-0207
- NPI assigned
- Jan 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | S08623597 | MA | |
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
300 E Main St
Milford, MA 01757-2806
Mailing address
48 Artisan Way
Forestdale, MA 02644-1928
Phone (781) 974-6735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S08623597 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1043961089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 ARTISAN WAY",
"city": "FORESTDALE",
"state": "MA",
"postal_code": "026441928",
"telephone_number": "781-974-6735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E MAIN ST",
"city": "MILFORD",
"state": "MA",
"postal_code": "017572806",
"telephone_number": "508-478-0207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "TYLER",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-11",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "S08623597",
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.