Brandy Tydingco, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P1607073 Issued in AR

Practice address

300 N Clifton St
Fordyce, AR 71742-3055

Phone

(870) 352-5122

Fax

(870) 352-5127

NPI assigned

Feb 7, 2014

Last updated

Jul 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1073937207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N CLIFTON ST",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "717423055",
            "telephone_number": "870-352-5122",
            "fax_number": "870-352-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N CLIFTON ST",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "717423055",
            "telephone_number": "870-352-5122",
            "fax_number": "870-352-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYDINGCO",
        "first_name": "BRANDY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1607073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fordyce, AR
• Providers in Fordyce, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.