Tyler Clearwater, APSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9567-123 Issued in WI

Practice address

320 S Walnut St
Appleton, WI 54911-5918

Phone

(920) 832-5270

Fax

(920) 832-4767

NPI assigned

Mar 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Outagamie

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1629138995
  NPD

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1447886809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S WALNUT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S WALNUT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARWATER",
        "first_name": "TYLER",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131043-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9567-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098292",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth F Clark, MSC, PA-C
• Kristine J. Clark, O.T.C.
• S. William Clark, D.D.S.
• Kathleen Anne Clarke
• Kendra Clayton
• Shirley Louise Clemmons, BC-HIS
• Cloverleaf Counseling, LLC
• CM Romenesko DDS SC
• Cmwl2
• Thomas G Cody

• Clinical Social Worker in Appleton, WI
• Providers in Appleton, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.