John Carlin Tiedemann, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106643 Issued in NY

Practice address

19 Union SQ W
New York, NY 10003-3304

Phone

(212) 627-9600

NPI assigned

Nov 22, 2021

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1639836869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 15TH ST APT 7F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033537",
            "telephone_number": "917-348-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 UNION SQ W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033304",
            "telephone_number": "212-627-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDEMANN",
        "first_name": "JOHN",
        "middle_name": "CARLIN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "106643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ruth Tidwell, LCSW
• Edward Tie, MD
• John Gerard Tie, LCSW
• Matthew R Tiede I, PA-C
• Devany Tiedeman, MSPT
• Vera Tiedje
• Malik Tiedt, MS, RDN
• Leonore Tiefer, PHD
• Alanna Tieman
• Johanna Marjorie Tiemann, PH.D.

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.