Active NPI
Tyler James Brent, LCSW
- Clinical Social Worker
- Mandeville, LA
National Provider Identifier
1700489978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14340
- Practice address
- 2810 E Causeway Approach
Mandeville, LA 70448-3502 - Phone
- (985) 898-7420
- Fax
- (985) 898-7271
- NPI assigned
- Nov 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 14340 | LA | Primary |
Addresses
Primary practice location
2810 E Causeway Approach
Mandeville, LA 70448-3502
Mailing address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14340 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625702400000",
"number": "1700489978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 JEFFERSON HWY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701212429",
"telephone_number": "504-842-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 E CAUSEWAY APPROACH",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704483502",
"telephone_number": "985-898-7420",
"fax_number": "985-898-7271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENT",
"first_name": "TYLER",
"middle_name": "JAMES",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-19",
"last_updated": "2021-07-08",
"certification_date": "2021-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "14340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.