TYLER RICHARDSON (LCSW) – Counselor, NPI 1386266708

TYLER RICHARDSON (LCSW) is a healthcare provider. based in Rexburg, Idaho. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LMSW-42391 (ID). The NPI Number for TYLER RICHARDSON (LCSW) is 1386266708

Main info

Male
4 Years Of Experience
Name
TYLER RICHARDSON (LCSW)
NPI
1386266708
Phone
(208) 359-4840
Address
393 E 2ND N
Enumeration Date
7 May 2020
Last Update Date
12 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
9234658253
Professional Enrollment ID
I20250522002099
Address ID
ID834401605RE393XX2NDX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:6State licenses:2Digital endpointsOther names

633 CLINICAL SOCIAL WORKER in ID

Provider Addresses for TYLER RICHARDSON (LCSW)

  • 393 E 2ND N

    REXBURG, ID 834401605

    Phone: (208) 359-4840

    Fax: (208) 359-9010

    Type: Location

  • 3453 Clearview Ln

    Ammon, ID 834064702

    Phone: (208) 359-4840

    Fax: (208) 359-9010

    Type: Location

  • 2240 N HWY 89 STE C

    HARRISVILLE, UT 844042824

    Phone: (801) 393-6232

    Fax: (801) 393-4081

    Type: Mailing

  • 180 S 600 W

    LOGAN, UT 843215026

    Phone: (801) 393-6232

    Fax: (801) 393-4081

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250522002099IClinical Social WorkerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83440)

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Reviews

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Frequently asked questions

Does TYLER RICHARDSON (LCSW) have a public NPI I can cite?
Public records show TYLER RICHARDSON (LCSW) under NPI 1386266708.
Is TYLER RICHARDSON (LCSW)'s NPI status active today?
Active status means TYLER RICHARDSON (LCSW)'s NPI record is not deactivated in the public file.
What does the directory say TYLER RICHARDSON (LCSW) does?
Insurance directories may phrase it differently, but here TYLER RICHARDSON (LCSW) maps to Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to TYLER RICHARDSON (LCSW)?
TYLER RICHARDSON (LCSW) shows a connection to Rexburg, Idaho in registry-derived data.
Who maintains TYLER RICHARDSON (LCSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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