Tyne K McCreadie, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

084931-1 Issued in NY

Practice address

28 William St
Gouverneur, NY 13642-1405

Phone

(315) 287-2811

NPI assigned

Nov 8, 2012

Sex

Female

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

Opted out of Medicare

Yes, effective May 29, 2024 through May 29, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• St. Lawrence Psychiatric Center

  • Community/Behavioral Health Agency
  • Gouverneur, NY
  • NPI 1669811881
  NPD (past)
• St. Lawrence Psychiatric Center

  • Community/Behavioral Health Agency
  • Gouverneur, NY
  • NPI 1780135749
  NPD (past)

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1811241102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHIMNEY POINT DR",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692212",
            "telephone_number": "315-541-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WILLIAM ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421405",
            "telephone_number": "315-287-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREADIE",
        "first_name": "TYNE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "084931-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J. Luck, CASAC
• M B Kayani Physician PC
• Sharon Macdonald, LPN
• Coral Mahay
• Delaney Mason, RN
• Melvin McCue
• Meghan McGowan, CPNP-PC
• Drushti Mehta
• Suzanne Meyer
• Michael F Lapierre PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.