TYLER O BENELLI (LCSW) – Clinical Social Worker, NPI 1144510280

TYLER O BENELLI (LCSW) is a healthcare provider. based in Wellsboro, Pennsylvania. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. The NPI Number for TYLER O BENELLI (LCSW) is 1144510280

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
TYLER O BENELLI (LCSW)
NPI
1144510280
Phone
(570) 723-0620
Address
114 EAST AVE
Enumeration Date
11 April 2011
Last Update Date
1 June 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5702973746
Graduation Year
2010 (16 years ago)
PAC ID
5092031591
Group Practice PAC ID
0446245880
Professional Enrollment ID
I20150227000604
Address ID
PA169479529TR45XXXRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:15State licenses:0Digital endpointsOther names

2,438 CLINICAL SOCIAL WORKER in PA

Provider Addresses for TYLER O BENELLI (LCSW)

  • 114 EAST AVE

    WELLSBORO, PA 169011737

    Phone: (570) 723-0620

    Fax: (570) 724-0675

    Type: Location

  • 40 W WELLSBORO ST

    MANSFIELD, PA 169331411

    Phone: (570) 662-1982

    Fax: (570) 662-2390

    Type: Mailing

  • 40 W Wellsboro St

    Mansfield, PA 169331411

    Phone: (570) 662-1974

    Fax: (570) 662-2390

    Type: Location

  • 416 S Main St

    Mansfield, PA 169331510

    Phone: (570) 662-2002

    Fax: (570) 662-2025

    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: 2015-02-27

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
I20150227000604IClinical Social WorkerPATBD

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 16901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446245880View full group profile
NameSpecialtyState
Physician AssistantPA
Family PracticePA
Family PracticePA
Nurse PractitionerSC
Clinical Social WorkerPA
Sports Medicine, Family PracticePA
Clinical Social WorkerPA
Nurse PractitionerPA
Physician AssistantPA
P S Y C H I A T R YPA

Reviews

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Frequently asked questions

What identifier follows TYLER O BENELLI (LCSW) across health systems?
The NPI 1144510280 uniquely identifies TYLER O BENELLI (LCSW) in U.S. healthcare data.
Is TYLER O BENELLI (LCSW) currently accepting referrals based on NPI status?
Registry metadata lists TYLER O BENELLI (LCSW) as active.
Which specialty label fits TYLER O BENELLI (LCSW)?
NPPES ties TYLER O BENELLI (LCSW) to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is TYLER O BENELLI (LCSW) tied to Wellsboro, Pennsylvania?
If you are local to Wellsboro, Pennsylvania, TYLER O BENELLI (LCSW) may be relevant to your search.
Can I export TYLER O BENELLI (LCSW)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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