Individual provider Active NPI

Laura A. Tyson, MSW LCSW LCADC

  • Clinical Social Worker
  • Summit, NJ
National Provider Identifier
1275961245
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
450 Springfield Ave Ste 302
Summit, NJ 07901-2611
Phone
(917) 994-1199
NPI assigned
Oct 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X NJ Primary

Addresses

Primary practice location

450 Springfield Ave Ste 302
Summit, NJ 07901-2611

Mailing address

17 Johnson Dr
Chatham, NJ 07928-1124
Phone (917) 340-5203

Other practice location 1

655 E Jersey St
Elizabeth, NJ 07206-1259
Phone (908) 994-7131

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

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1275961245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 JOHNSON DR",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281124",
            "telephone_number": "917-340-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SPRINGFIELD AVE STE 302",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012611",
            "telephone_number": "917-994-1199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 E Jersey St",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072061259",
            "country_code": "US",
            "telephone_number": "908-994-7131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYSON",
        "first_name": "LAURA",
        "middle_name": "A.",
        "credential": "MSW LCSW LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.