Provider Demographics
NPI:1306269543
Name:TYSON, BARBARA J (CLENICIAN)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:J
Last Name:TYSON
Suffix:
Gender:F
Credentials:CLENICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 WALLACE ST
Mailing Address - Street 2:SAME
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119
Mailing Address - Country:US
Mailing Address - Phone:413-433-6204
Mailing Address - Fax:
Practice Address - Street 1:79 WALLACE ST
Practice Address - Street 2:SAME
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01119
Practice Address - Country:US
Practice Address - Phone:413-433-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA1265645261101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health