Tyra Dawn Boyd, LCSW

Key facts

NPI

1497053409

Entity type

Individual (NPI type 1)

Primary specialty

Case Manager/Care Coordinator 171M00000X

Practice address

69 Dogwood Ave
Mountain Home, TN 37684

Phone

(423) 926-1171

NPI assigned

Mar 1, 2011

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

Other names

• Tyra Dawn McNiel Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 31, 2025.

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1497053409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4000",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 DOGWOOD AVE",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "TYRA",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-01",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6319",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYRA",
            "last_name": "MCNIEL",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Mountain Home, TN · Case Manager/Care Coordinator in Tennessee