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

Individual provider Case Manager/Care Coordinator · NPI 1700168804

Tyler Dean Grissom, LCSW is a Clinical Social Worker in Eugene, Oregon. Qualified in 2012, 14 years ago. Practices with Peacehealth Medical Group, a 254-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
14
Licensed in
OR
In the registry since
2011
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1200 Hilyard St Ste 310
Eugene, OR 97401-8122
Phone: (458) 205-6709
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L7128 (OR)
Case Manager/Care Coordinator Taxonomy 171M00000X
Social Worker Taxonomy 104100000X

Record details

NPI number1700168804
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 14, 2011
Last updated in NPPESMarch 5, 2024
Certification dateMarch 5, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Peacehealth Medical Group — 254 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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