Individual provider Active NPI

Victoria Theresa Tylenda-Wong, LMSW

  • Clinical Social Worker
  • Royal Oak, MI
National Provider Identifier
1831352392
Registry record updated Jul 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801082431 Issued in MI
Practice address
415 S West St
Suite 150
Royal Oak, MI 48067-2521
Phone
(248) 341-0710
Fax
(248) 546-8070
NPI assigned
Jul 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2008

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 6801082431 MI Primary

Addresses

Primary practice location

415 S West St
Suite 150
Royal Oak, MI 48067-2521

Mailing address

415 S West St
Suite 150
Royal Oak, MI 48067-2521
Phone (248) 341-0710

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

NPI Registry JSON

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

{
    "created_epoch": "1215216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215216000000",
    "number": "1831352392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S WEST ST",
            "address_2": "SUITE 150",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672521",
            "telephone_number": "248-341-0710",
            "fax_number": "248-546-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S WEST ST",
            "address_2": "SUITE 150",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672521",
            "telephone_number": "248-341-0710",
            "fax_number": "248-546-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLENDA-WONG",
        "first_name": "VICTORIA",
        "middle_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-05",
        "last_updated": "2008-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801082431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2008; 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.