Tyra Lynn Williams, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11829243-3502 Issued in UT

Practice address

750 N Freedom Blvd Ste 300
Provo, UT 84601-1690

Phone

(801) 373-4760

NPI assigned

Aug 18, 2020

Last updated

Jul 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 UT

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wasatch Behavioral Health Special Service DistrictGroup PAC ID 2567367915, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wasatch Behavioral Health Special Service District

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1356357115
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1427660851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD STE 300",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD STE 300",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011690",
            "telephone_number": "801-373-4760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3726 E Campus Dr Ste H",
            "address_purpose": "LOCATION",
            "city": "Eagle Mountain",
            "state": "UT",
            "postal_code": "840054514",
            "country_code": "US",
            "telephone_number": "801-789-7780",
            "fax_number": "801-789-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TYRA",
        "middle_name": "LYNN",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11829243-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Layne Williams
• Lisa M Williams, NP
• Melissa Williams, FNP-C
• Michael Ray Williams, PHD
• T'Naiha Williams
• Katelyn Williamson
• Alika Marie Willis, NP-C
• Brooke Willis
• James Willis
• D Keith Willmore, MD

• Clinical Social Worker in Provo, UT
• Providers in Provo, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.