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

Q: 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.

Q: What is Candice Tyson's specialty?

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

Q: 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 13 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.

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: August 02, 2026.

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

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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 and is a graduate of Other (2022).

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

Medical School CMSOtherGraduated 2022

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID5395244651

PECOS Enrollment IDI20250814004693, I20250815002443

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.

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.

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 13 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.