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CANDICE LILLIAN TYSON LCPC
NPI 1164101218
Counselor - Mental Health in Baltimore, MD

Active since July 17, 2023PECOS Enrolled
1340 SMITH AVE STE 200, BALTIMORE, MD 21209(410) 779-1314(410) 779-1336 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 9, 2025, Oct 25, 2023, Jul 17, 2023 (3 updates tracked since 2023).

About Candice Lillian Tyson Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANDICE LILLIAN TYSON LCPC (NPI 1164101218) is an individual mental health provider in Baltimore, Maryland, licensed in Maryland (LC16566) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164101218
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameCANDICE LILLIAN TYSONCredential: LCPC
Location Address1340 SMITH AVE STE 200Baltimore, MD 21209-3796
Mailing Address1340 Smith Ave Ste 200Baltimore, MD 21209-3796 · (410) 779-1314 · Fax (410) 779-1336
Phone(410) 779-1314
Fax(410) 779-1336
Sole ProprietorNo
Enumeration DateJuly 17, 2023
Last NPPES UpdateJune 9, 20253 updates tracked since enumeration
NPPES CertifiedJune 9, 2025
✔ NPI 1164101218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MD · LC16566
Also ListedCounselorTaxonomy 101Y00000X · License LC16566 (MD)
1340 SMITH AVE STE 200, Baltimore, MD 21209
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Candice Lillian Tyson Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Candice Tyson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Quince Orchard Psychotherapy LLC
35 mi
Psychiatry
9707 KEY WEST AVE STE 100
Rockville, MD 20850
  • Reassigned Medicare billing, District of Columbia and Maryland enrollments
  • 44 clinicians in this Medicare group
NPI 1336670389 (240) 750-6467

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOPE & FONDER LLC
Home Health
1340 SMITH AVE STE 200
BALTIMORE, MD 21209
Baltimore County (410) 779-1214
TRANSITIONAL CARE SERVICES INC
Community/Behavioral Health
1340 SMITH AVE STE 200
BALTIMORE, MD 21209
Baltimore County (443) 250-9989
KENNETH G MUTHEE
Nurse Practitioner (Psychiatric/Mental Health)
1340 SMITH AVE STE 200
BALTIMORE, MD 21209
Baltimore County (443) 500-9251

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Candice Tyson's NPI number?

The NPI number for Candice Tyson is 1164101218. It was assigned to this individual provider in the NPPES registry on July 17, 2023.

Where is Candice Tyson located?

Candice Tyson practices at 1340 Smith Ave Ste 200, Baltimore, MD 21209. The listed phone number is (410) 779-1314.

What is Candice Tyson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Candice Tyson enrolled in Medicare?

Yes. Candice Tyson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Candice Tyson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Candice Tyson reassigns Medicare benefits to Quince Orchard Psychotherapy LLC (Rockville, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Candice Tyson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Candice Tyson was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.