Individual provider Active NPI

Tyonna Dashawn Butler-Foster

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1245068865
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P020961 Issued in NC
Practice address
769 N Wendover Rd
Charlotte, NC 28211-1118
Phone
(704) 376-7180
NPI assigned
Jul 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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 P020961 NC Primary

Addresses

Primary practice location

769 N Wendover Rd
Charlotte, NC 28211-1118

Mailing address

6800 Saint Peters LN
Matthews, NC 28105-8458
Phone (704) 376-7180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P020961NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Community Services, LLC Clinical Past Accepting new patients
Family First Community Services LLC Past Accepting new patients

Organizations & group practices 2

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": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1245068865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SAINT PETERS LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281058458",
            "telephone_number": "704-376-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 N WENDOVER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111118",
            "telephone_number": "704-376-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER-FOSTER",
        "first_name": "TYONNA",
        "middle_name": "DASHAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P020961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.