Individual provider Active NPI

Tyler Curt Huffaker, LCSW

  • Clinical Social Worker
  • Logan, UT
National Provider Identifier
1962634436
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
84160223501 Issued in UT
Practice address
60 E Center St
Suite 112
Logan, UT 84321-4664
Phone
(435) 757-3670
Fax
(888) 380-4476
NPI assigned
Aug 18, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC13359 ME
Clinical Social Worker 1041C0700X 84160223501 UT Primary

Addresses

Primary practice location

60 E Center St
Suite 112
Logan, UT 84321-4664

Mailing address

60 E Center St Ste 112
Logan, UT 84321-4659
Phone (435) 757-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20151228000590 ME Practitioner - Clinical Social Worker 8527211622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spurwink Services IncorporatedGroup PAC ID 7810026945, 87 clinicians

Practice addresses (Care Compare)

9 Hillcrest Ave
Randolph, ME 04346-5131
Phone (207) 582-9205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
84160223501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spurwink Services Incorporated CurrentSince Feb 20, 2017 Accepting new patients
Bear River Mental Health Services Inc PastSince Jun 7, 2005 Accepting new patients

Locations

180 Main St
Biddeford, ME 04005
Phone (207) 283-0587

901 Washington Ave
Ste 100
Portland, ME 04103
Phone 20787112112145

9 Hillcrest Ave
Randolph, ME 04346
Phone (207) 582-9205

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1962634436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E CENTER ST STE 112",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214659",
            "telephone_number": "435-757-3670",
            "fax_number": "888-380-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E CENTER ST",
            "address_2": "SUITE 112",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214664",
            "telephone_number": "435-757-3670",
            "fax_number": "888-380-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFAKER",
        "first_name": "TYLER",
        "middle_name": "CURT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-18",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13359",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "84160223501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.