Emily C Tyson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003673 Issued in CT

Practice address

90 S Park St Ste 2
Willimantic, CT 06226-3336

Phone

(860) 207-0499

NPI assigned

Jun 2, 2019

Sex

Female

Sole proprietor

No

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 CT

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CT, Professional

  Medicare reassignment NPD
• Authentic Therapy Co

  • Mental Health Counselor
  • West Hartford, CT
  • NPI 1811848260
  NPD Authorized official
• Nafi Connecticut Inc.

  • Clinic/Center
  • Hartford, CT
  • NPI 1619258449
  NPD (past)

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

{
    "created_epoch": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559433600000",
    "number": "1487212734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S PARK ST STE 2",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263336",
            "telephone_number": "860-207-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S PARK ST STE 2",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263336",
            "telephone_number": "860-207-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "EMILY",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-02",
        "last_updated": "2019-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore Tresca Jr., C.R.N.A.
• Tricounty Vision Associates, L.L.C.
• Andrew An Trinh, MD
• Dawn Truong
• John Tutu
• Judith Chinenye Ukabam, M.D.
• United Services
• Kathryn Frances Vaida, RPT
• McKenna L Valenti
• Ellen Vangelakos

• Professional Counselor in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2019; 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.