Tyson, Jeanette Marlene
Tyson, Jeanette Marlene is an individual health care provider with primary practice located at 160 Garfield Pl , South Orange NJ 07079-2107. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Tyson, Jeanette Marlene can be contacted via phone (973) 738-3823.Contact Information
Primary practice address
160 Garfield Pl
South Orange NJ 07079-2107
Phone: (973) 738-3823
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 44SL05287200 | New Jersey |
Profile Details
| NPI number | 1407059793 |
|---|---|
| LBN Legal business name | Tyson, Jeanette Marlene |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2007 |
| Last updated | Dec 3rd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407059793 | NPPES |
| New Jersey | Other | 160092 | MEDICARE TPAN |
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