Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Jaclyn Tyson

Individual provider Clinical Social Worker · NPI 1124692629

Mrs. Jaclyn Tyson is a Clinical Social Worker in Raleigh, North Carolina. Works from 2 locations. Licensed in North Carolina and New Jersey.

Licensed in
NC, NJ
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

715 W Morgan St
Raleigh, NC 27603-1611
Phone: (919) 977-0087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 504 Old Cypress Dr, Winston Salem, NC 27127-6099 — (201) 988-3025

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence P012163 (NC)
Clinical Social Worker Taxonomy 1041C0700X · Licence P012163 (NJ)

Record details

NPI number1124692629
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 18, 2021
Last updated in NPPESMay 18, 2021
Certification dateMay 17, 2021

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