Tyra Lynn Humphrey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9872 Issued in FL

Practice address

710 94TH Ave N Ste 305
Saint Petersburg, FL 33702-2452

Phone

(727) 377-9388

Fax

(727) 290-4047

NPI assigned

Jul 13, 2011

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1881982684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 94TH AVE N STE 305",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022452",
            "telephone_number": "727-377-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 94TH AVE N STE 305",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337022452",
            "telephone_number": "727-377-9388",
            "fax_number": "727-290-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "TYRA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humble Hydrations Mental Wellness & Growth, LLC.
• Bailey Hummel
• Katie Dorothy Hummel
• Olivia Grace Humpel, DO, MPH
• Edwin Jacob Humphrey IV, M.D.
• Jan S Humphreys, ARNP-C
• Andrea Sue Hunsinger, MA; CCC/SLP
• Christen Hunt, APRN
• Kadijah Chontae Hunt, HAIR LOSS SPECIALIST
• Samantha Rose Hunt, ARNP

• Clinical Social Worker in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.