SHAWN TYSON (NPI# 1164064044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164064044 |
| Entity Type | Individual |
| Full Name | SHAWN TYSON |
| Practice Address |
330 Main St Fl 1 Hartford CT 06106-1851 |
| Mailing Address |
Po Box 331271 West Hartford CT 06133-1271 |
| Practice Telephone | 8607789078 |
| Mailing Telephone | 8607789078 |
| Enumeration Date | 2019-10-12 |
| Last Update Date | 2019-10-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1329 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1329 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295943173 | Shawn Thomas Tyson | Chiropractor | 11037 Hull Street Rd, Midlothian, VA 23112-3254 | 2007-05-21 |
| Street Address |
330 MAIN ST FL 1 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106-1851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114401510 | Roberto Carlos Vargas | Counselor | 926 Asylum Ave Apt 206, Hartford, CT 06105-2402 | 2018-09-20 |
| 1053859553 | Michael Heaven | Counselor | 601 Blue Hills Ave, Apt B2, Hartford, CT 06112-1254 | 2017-02-03 |
| 1043678063 | Daisy Baez | Counselor | 59 Nelson St, Hartford, CT 06120-2041 | 2016-02-04 |
| 1821495391 | Halcyon Clinical Services, LLC | Counselor | 75 Charter Oak Ave, Hartford, CT 06106-1903 | 2014-11-29 |
| 1346654399 | Edward Gonzalez | Counselor | 27 May Street 2nd Floor, Hartford, CT 06104 | 2014-06-18 |
| 1306100367 | Marco Neves | Counselor | 106 Standish St, Hartford, CT 06114-2936 | 2012-06-25 |
| 1275804874 | Ray T. Bishop | Counselor | 16 Weston St, Hartford, CT 06120-1504 | 2012-01-13 |
| 1144591710 | Philip Frederick Richmond | Counselor | 18 Weston St, Hartford, CT 06120-1504 | 2012-01-13 |
| 1871862789 | Latino Community Services, Inc. | Counselor | 221 Main St Fl 3, Hartford, CT 06106-1890 | 2011-12-21 |
| 1851670046 | Samuel Diaz | Counselor | 45 Wardsworth St., Hartford, CT 06106 | 2011-08-05 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.