Tyric Awosanya

Individual provider Active NPI Behavior Technician · Sumter, SC

NPI 1831900570 · NPPES record last updated Jan 14, 2025

Key facts

NPI
1831900570
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
738 W Liberty St Ste B
Sumter, SC 29150-4745
Phone
(803) 757-1744
NPI assigned
Jan 14, 2025
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
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Depot LLC Past
since Jan 19, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

738 W Liberty St Ste B
Sumter, SC 29150-4745

Mailing address

738 W Liberty St Ste B
Sumter, SC 29150-4745
Phone (803) 757-1744

Other providers in Sumter, SC

All providers in Sumter, SC · Behavior Technician in South Carolina

Sources for this page

Verify at the official NPI Registry.