Individual provider Active NPI

Tyra S Flowers, LCSW

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1144988833
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-22864 Issued in AZ
Practice address
4121 E Valley Auto Dr Ste 122
Mesa, AZ 85206-4632
Phone
(602) 285-9696
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-22864 AZ Primary

Addresses

Primary practice location

4121 E Valley Auto Dr Ste 122
Mesa, AZ 85206-4632

Mailing address

4121 E Valley Auto Dr Ste 122
Mesa, AZ 85206-4632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20251111001147 AZ Practitioner - Clinical Social Worker 0648761346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4121 E Valley Auto Dr
Suite 122
Mesa, AZ 85206-4632
Phone (602) 285-9696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-22864AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Sep 25, 2025 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Current Accepting new patients
Northlight Counseling Associates Inc Mental Health CurrentSince Sep 12, 2025 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Sep 25, 2025 Accepting new patients

Locations

4121 E Valley Auto Dr
Ste 122
Mesa, AZ 85206
Phone (602) 285-9696

Interoperability endpoints

  • Direct secure messaging: tyra.flowers.1@28621.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1144988833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DR STE 122",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DR STE 122",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064632",
            "telephone_number": "602-285-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOWERS",
        "first_name": "TYRA",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.