Dymir R Tatem, LCSW, CSSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05934000 Issued in NJ

Practice address

3000 Atrium Way
Suite 200 #2207
Mount Laurel, NJ 08054

Phone

(609) 503-0484

NPI assigned

Aug 16, 2020

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

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Fresh Start Counseling LLC

  • Clinical Social Worker
  • Williamstown, NJ
  • NPI 1720821028
  NPD Authorized official
• Fresh Start Counseling LLC

  • Mental Health Counselor
  • Voorhees, NJ
  • NPI 1861281867

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1597536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1154932713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ATRIUM WAY",
            "address_2": "SUITE 200 #2207",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080942176",
            "telephone_number": "609-503-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ATRIUM WAY",
            "address_2": "SUITE 200 #2207",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "08054",
            "telephone_number": "609-503-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATEM",
        "first_name": "DYMIR",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW, CSSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05934000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Listiani Tan, M.D.
• Vincent J. Taormina, M.D.
• Mark A Tarangioli, PSY.D. LLC
• Carolyn Tassini
• Terlayra Antonette Tate
• Beth Taylor, APNC
• Madalynn Ann Taylor
• Techforce Counseling & Community Services Inc
• Mia Nicole Teel Neely
• Tempus Medical Services Corporation

• Clinical Social Worker in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.