Bryan Tyer-Witek

Individual provider Active NPI Mental Health Counselor · Middletown, RI

NPI 1780058412 · NPPES record last updated Feb 20, 2024

Key facts

NPI
1780058412
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
58 E Main Rd
Middletown, RI 02842-4988
Phone
(401) 608-3322
Fax
(401) 608-3323
NPI assigned
Nov 18, 2015
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240215001514 RI Practitioner - Mental Health Counselor 7315381597 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Newport County Community Mental Health Center, Inc Current
since Jan 1, 2024
Accepting new patients

Locations

42 Valley Rd
Middletown, RI 02842
Phone (401) 843-1213

127 Johnny Cake Hill Rd
Middletown, RI 02842

65 Valley Rd
Middletown, RI 02842
Phone (401) 431-9870

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

58 E Main Rd
Middletown, RI 02842-4988

Mailing address

58 E Main Rd
Middletown, RI 02842-4988
Phone (401) 608-3322

Other identifiers

IdentifierTypeStateIssuer
1780058412MedicaidRI

Other providers in Middletown, RI

All providers in Middletown, RI · Mental Health Counselor in Rhode Island

Sources for this page

Verify at the official NPI Registry.