Individual provider Active NPI

Michael Francis Tyler, LCSW

  • Clinical Social Worker
  • Bloomfield, CT
National Provider Identifier
1689324170
Registry record updated Mar 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003359 Issued in CT
Practice address
701 Cottage Grove Rd Ste E230
Bloomfield, CT 06002-4211
Phone
(860) 880-0301
NPI assigned
Mar 27, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 003359 CT Primary

Addresses

Primary practice location

701 Cottage Grove Rd Ste E230
Bloomfield, CT 06002-4211

Mailing address

28 Guernsey Rd
Bloomfield, CT 06002-3420
Phone (860) 508-5909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
003359CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ebb and Flow Counseling, LLC Clinical CurrentSince May 29, 2022 Accepting new patients

Locations

701 Cottage Grove Rd
Ste E230
Bloomfield, CT 06002
Phone (860) 351-3072

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648339200000",
    "number": "1689324170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 GUERNSEY RD",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023420",
            "telephone_number": "860-508-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD STE E230",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060024211",
            "telephone_number": "860-880-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "MICHAEL",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-27",
        "last_updated": "2022-03-27",
        "certification_date": "2022-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2022; 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.