Individual provider Active NPI

Deborah K. Tyson, PHD

  • Counseling Psychologist
  • Miami, FL
National Provider Identifier
1275517005
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY4181 Issued in FL
Practice address
7700 North Kendall Drive
Suite 413
Miami, FL 33156-7565
Phone
(305) 595-8225
Fax
(305) 596-6947
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY4181 FL
Counseling Psychologist 103TC1900X PY4181 FL Primary

Addresses

Primary practice location

7700 North Kendall Drive
Suite 413
Miami, FL 33156-7565

Mailing address

9021 SW 94 Street
Apt 208
Miami, FL 33176-2311
Phone (305) 595-8225

Other identifiers 1

IdentifierTypeStateIssuer
73459OtherFLBCBS

Other names 1

  • Ms. Deborah Tyson Rodriguez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100311000716 FL Practitioner - Clinical Psychologist 6002941317 Practice locations: Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Miami, LM Miller School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9021 SW 94TH St
Apt 208
Miami, FL 33176-2112
Phone (305) 595-8225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY4181FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1275517005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9021 SW 94 STREET",
            "address_2": "APT 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762311",
            "telephone_number": "305-595-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 NORTH KENDALL DRIVE",
            "address_2": "SUITE 413",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567565",
            "telephone_number": "305-595-8225",
            "fax_number": "305-596-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "DEBORAH",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4181",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY4181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "73459",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "RODRIGUEZ",
            "middle_name": "TYSON",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.