Shawn Tyson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1329 Issued in CT

Practice address

330 Main St FL 1
Hartford, CT 06106-1851

Phone

(860) 778-9078

NPI assigned

Oct 12, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1570838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570838400000",
    "number": "1164064044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331271",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061331271",
            "telephone_number": "860-778-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MAIN ST FL 1",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061851",
            "telephone_number": "860-778-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-12",
        "last_updated": "2019-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1329",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Tyksinski, APRN
• Christopher Tynan
• Macdara Gerard Tynan, MD
• Patricia Lynn Tyndale, RD
• Jessica Tyrol, LPC
• Valerie A Tyson, RN
• Vernette Tyson
• Rebecca Ye U, PA-C
• Kiran Ubriani, M.D.
• Syed Mohammad Mazhar Uddin, MBBS

• Addiction (Substance Use Disorder) Counselor in Hartford, CT
• Providers in Hartford, CT by specialty
• Addiction (Substance Use Disorder) Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.