Antonio Lamar Wyche, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14171 Issued in FL

Practice address

4047 Ailanthus CT
Tallahassee, FL 32305-5003

Phone

(386) 466-2733

NPI assigned

Sep 24, 2020

Sex

Male

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

Enrolled in FL, GA2 enrollments

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 2

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 and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, GA

  Medicare reassignment NPD
• Renewing Minds Counseling and Consulting Services, LLC

  • Mental Health Counselor
  • Tallahassee, FL
  • NPI 1023615846
  NPD Authorized official

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1194332056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 AILANTHUS CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323055003",
            "telephone_number": "386-466-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 AILANTHUS CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323055003",
            "telephone_number": "386-466-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCHE",
        "first_name": "ANTONIO",
        "middle_name": "LAMAR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Lance Wright, PHD
• Twila Monisa Wright, RPH
• Jinlin Wu
• Cathy Nmi Wuest-Stromberg, LMFT715
• Amber Wyartt, PHLEBOTOMIST
• Tiara Wynn
• Artemis Demetra Xenick, MT-BC
• William M Yaakob, MD
• Kathleen Knox Yale, ED. D.
• Melanie R Yale, BS LMT NMT

• Clinical Social Worker in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.