Jeni Tyson LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05337100 Issued in NJ

Legal business name

JENI TYSON LCSW LLC

Practice address

2115 Millburn Ave Ste 105
Maplewood, NJ 07040-3724

Phone

(973) 738-3823

Fax

(973) 378-5577

NPI assigned

Jul 29, 2014

Organization subpart

No

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

Authorized official

Name

Jeanette M Tyson, L.C.S.W.NPI 1407059793

Title

Owner

Phone

(973) 738-3823

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeanette Marlene Tyson, L.C.S.W.

  • Social Worker
  • South Orange, NJ
  • NPI 1407059793
  NPD (past) Authorized official

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1427466838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 MILLBURN AVE STE 105",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403724",
            "telephone_number": "973-738-3823",
            "fax_number": "973-378-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 MILLBURN AVE STE 105",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403724",
            "telephone_number": "973-738-3823",
            "fax_number": "973-378-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENI TYSON LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-738-3823",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05337100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abhijeet Jyotindra Jatania, RPH
• Subendrini Gunasundari Jayanathan, M.D.
• Alexandra Rosette Jean
• Reynald Jean, NURSE
• Sheron D. Jefferson, ED.D.
• Jespy House
• Jessica Auth, PHD LLC
• Jewish Service for the Developmentally Disabled of Metrowest, Inc.
• Jewish Service for the Developmentally Disabled of Metrowest, Inc.
• Sujata K. Jhaveri, MD

• Clinical Social Worker in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.