Tyler Thompson Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12097-123 Issued in WI

Practice address

199 County DF
Juneau, WI 53039-9512

Phone

(920) 386-3500

NPI assigned

Apr 13, 2023

Last updated

Feb 26, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of DodgeGroup PAC ID 2466475587, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• County of Dodge

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Juneau, WI
  • NPI 1871508515
  Medicare reassignment Care Compare group NPD
• County of Dodge

  • Public Health or Welfare Agency
  • Juneau, WI
  • NPI 1811102049
  NPD
• Healing Hearts Family Counseling Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sun Prairie, WI
  • NPI 1972824571
  NPD (past)

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1093401929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 MIDGE ST",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "53038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COUNTY DF",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "530399512",
            "telephone_number": "920-386-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYLER",
        "middle_name": "THOMPSON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-13",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12097-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth J Schober, COTA
• Gretchen Schroeder
• Alyssa R Schultz, M.S.
• Jennifer Lee Scott, R.N.
• Kelly Smith
• Mary Sobotka, COTA/L
• Alayne E Stelsel, M.A., PC
• Dana Marie Stinnett, NP
• Brigette Stockhausen
• Kathleen Stockhausen

• Clinical Social Worker in Juneau, WI
• Providers in Juneau, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.