Michael Andrew Tyskiewicz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008392 Issued in CT

Practice address

474 School St
East Hartford, CT 06108-1149

Phone

(860) 289-8131

NPI assigned

Jul 9, 2010

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1912219783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 STRAWBERRY LN",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406930",
            "telephone_number": "860-416-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 SCHOOL ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061081149",
            "telephone_number": "860-289-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSKIEWICZ",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in East Hartford, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.